Purpose: To evaluate in an in vitro model the feasibility and accuracy of Roentgen stereophotogrammetric analysis (RSA) versus computed tomography (CT) for the ability to detect stent-graft migration. Methods: An aortic model was constructed from a 22-mm-diameter Plexiglas tube with 6-mm polytetrafluoroethylene inlays to mimic the renal arteries. Six tantalum markers were placed in the wall of the aortic tube proximal to the renal arteries. Another 6 markers were added to a Gianturco stent, which was cast in Plexiglas and placed inside the aorta and fixed to a micromanipulator to precisely control displacement of the stent along the longitudinal axis. Sixteen migrations were analyzed with RSA software and compared to the micromanipulator. Thirty-two migrations were measured by 3 observers from CT images acquired with 16×0.5-mm beam collimation and reconstructed with a 0.5-mm slice thickness and a 0.4-mm reconstruction interval. Measurements were made with Vitrea postprocessing software using a standard clinical protocol and central lumen line reconstruction. Results of CT were also compared to the micromanipulator. Results: The mean RSA measurement error compared to the micromanipulator was 0.002±0.044 mm, and the maximum error was 0.10 mm. There was no statistically significant interobserver variability for CT (p=0.17). The pooled mean (maximum) measurement error of CT was 0.14±0.29 (1.00) mm, which was significantly different from the RSA measurement error (p<0.0001). Conclusion: Detection of endograft migration by RSA is feasible and was significantly more accurate than CT in this nonpulsatile in vitro model.

Computed tomography, Endograft, Endovascular aneurysm repair, Experimental model, Migration, Observer variation, Roentgen stereophotogrammetric analysis, Stent-graft
dx.doi.org/10.1583/06-1842MR.1, hdl.handle.net/1765/62218
Journal of Endovascular Therapy
Biophysical Genomics, Department Cell Biology & Genetics

Koning, O.H.J, Oudegeest, O.R, Valstar, E.R, Garling, E.H, van der Linden, E, Hinnen, J.-W, … van Bockel, J.H. (2006). Roentgen stereophotogrammetric analysis: An accurate tool to assess stent-graft migration. Journal of Endovascular Therapy, 13(4), 468–475. doi:10.1583/06-1842MR.1