Endograft Conformability and Aortoiliac Tortuosity in Endovascular Abdominal Aortic Aneurysm Repair
Bibliographic record
Abstract
PURPOSE: To determine conformability of stent-grafts in endovascular aneurysm repair (EVAR) using centerline of flow measurements and to compare conformability in patients with severe aortoiliac tortuosity. METHODS: From 2012 to 2013, 111 consecutive patients (98 men; mean age 75.4±7.7 years) underwent endovascular aneurysm repair with Endurant I and II and Zenith Flex, LP, and Spiral Z stent-grafts; their pre- and post-EVAR computed tomography (CT) studies were retrospectively analyzed using quantitative 3-dimensional imaging software. The length between the lowest renal artery and the iliac bifurcation was measured using centerline of flow and was defined as the treatment length (TL). The difference in TLs pre and post EVAR were compared as a surrogate to evaluate endograft conformability. RESULTS: A total of 203 pre and post EVAR aortoiliac TLs were measured (99 Endurant I, 20 Endurant II, 32 Flex, 6 LP, and 42 Spiral Z). Overall, there was a mean difference of 5.0±7.3 mm or 2.6%±3.9% between the pre- and post-EVAR TLs (p<0.001). No statistically significant difference in TLs was observed among the various stent-grafts (p=0.115). In 40 patients with severe aortoiliac tortuosity, the post-EVAR TL was 16.2±5.5 mm or 8.0%±2.7% shorter than the pre-EVAR TL (p<0.001); again, there was no difference in TLs among the various devices implanted (p=0.737). CONCLUSION: Overall, there was no difference in treatment lengths before and after EVAR among different stent-grafts, suggesting similar conformability. Interestingly, patients with severe aortoiliac tortuosity were found to have significantly shorter post-EVAR treatment lengths compared to before EVAR, which should be considered when planning EVAR.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".