Aortic remodeling after endovascular aneurysm repair

Aortic remodeling after endovascular aneurysm repair (EVAR) may explain underlying causes of long-term complications after EVAR. The first subject of this thesis compares aortic remodeling after insertion of an Anaconda endograft to aortic remodeling after an Endurant endograft. Aortic remodeling was defined as the change in curvature measured on pre- and postoperative computed tomography angiography (CTA) scans. However, measurements were performed by different observers and this thesis showed moderate intra- and interobserver agreement for curvature measurements. As excellent agreement was observed for dimensional measurements, aortic remodeling was determined based on diameters alone. Moreover, a study within the present research line compares the in vivo motions between two types of iliac branched devices on retrospective electrocardiogram (ECG)-gated CTA scans. The patient cohort with the first device was scanned with an scan protocol reconstructing 8 cardiac phases, while the other cohort used 10 cardiac phases. Therefore the second subject of this thesis was to assesses to what extent this phase difference can induce a difference in detected motions using an in vitro experiment. Moreover, an explorative patient study was performed to assess the results in clinical setting.