Three-dimensional bending, torsion and axial compression of the femoropopliteal artery during limb flexion
Three-dimensional bending, torsion and axial compression of the femoropopliteal artery during limb flexion
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DOI：
10.1016/j.jbiomech.2014.04.053
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发表时间：
2014-07-18
影响因子：
2.4
通讯作者：
Kamenskiy, Alexey V.
中科院分区：
文献类型：
--
作者：
MacTaggart, Jason N.;Phillips, Nicholas Y.;Kamenskiy, Alexey V.
股腘动脉重建的高失败率通常归因于肢体运动时发生的复杂 3D 动脉变形。本研究的目的是开发一种准确评估这些变形的方法。使用荧光镜检查将定制的不锈钢标记物部署到 5 个原位尸体股腘动脉中。在每个肢体处于笔直和急剧弯曲状态时获取薄切片 CT 图像。图像分割和 3D 重建可以比较每个动脉内标记位置的相对位置，以确定动脉的弯曲、扭转和轴向压缩。成像后，切除每条动脉，使用 Verhoeff-Van Gieson 染色进行组织学分析。股腘动脉变形不均匀，近端股浅动脉、内收肌裂孔和远端腘动脉之间存在高度局部变形。最大的弯曲（11 +/- 3-6 +/- 1 毫米曲率半径）、扭转（28 +/- 9-77 +/- 27 度/厘米）和轴向压缩（19 +/- 10-30 +/- 8%）在内收肌裂孔和膝下腘动脉处记录。这些变形比目前文献报道的值严重 3.7、19 和 2.5 倍。组织学显示明显的纵向弹性蛋白纤维下外膜层，在变形最大的节段中内膜增厚。这种血管内动脉内标记技术可以量化膝关节屈曲期间股腘动脉的不均匀 3D 变形，而不会干扰周围结构。我们证明，弯曲下肢的 3D 动脉弯曲、扭转和压缩是高度局部化的，并且比之前报道的严重得多。 (C) 2014 Elsevier Ltd. 保留所有权利。
High failure rates of femoropopliteal artery reconstruction are commonly attributed to complex 3D arterial deformations that occur with limb movement. The purpose of this study was to develop a method for accurate assessment of these deformations. Custom-made stainless-steel markers were deployed into 5 in situ cadaveric femoropopliteal arteries using fluoroscopy. Thin-section CT images were acquired with each limb in the straight and acutely bent states. Image segmentation and 3D reconstruction allowed comparison of the relative locations of each intra-arterial marker position for determination of the artery's bending, torsion and axial compression. After imaging, each artery was excised for histological analysis using Verhoeff-Van Gieson staining. Femoropopliteal arteries deformed non-uniformly with highly localized deformations in the proximal superficial femoral artery, and between the adductor hiatus and distal popliteal artery. The largest bending (11 +/- 3-6 +/- 1 mm radius of curvature), twisting (28 +/- 9-77 +/- 27 degrees/cm) and axial compression (19 +/- 10-30 +/- 8%) were registered at the adductor hiatus and the below knee popliteal artery. These deformations were 3.7, 19 and 2.5 fold more severe than values currently reported in the literature. Histology demonstrated a distinct sub-adventitial layer of longitudinally oriented elastin fibers with intimal thickening in the segments with the largest deformations. This endovascular intra-arterial marker technique can quantify the non-uniform 3D deformations of the femoropopliteal artery during knee flexion without disturbing surrounding structures. We demonstrate that 3D arterial bending, torsion and compression in the flexed lower limb are highly localized and are substantially more severe than previously reported. (C) 2014 Elsevier Ltd. All rights reserved.