Endovascular Repair of the Aorta: Stentgraft Deformation Matters

A dilatation of the main artery in the human body, also called an aortic aneurysm, is a form of cardiovascular disease that arises due to weakening of the vessel wall. If left untreated, an aortic aneurysm can rupture. Such a rupture results in life-threatening internal bleeding. Therefore, most aneurysms of a certain size are treated. This is often done through a puncture in the groin through which, via the arteries in the groin, a stent is placed in the aorta at the site of the aneurysm. This can also be imagined as placing a new inner tube: the blood now passes through this stent, which relieves the pressure of the weakend vessel wall and minimizes the risk of rupture. Although these operations are generally successful, in some cases it is still necessary to operate again. Reasons are, for example, that the stent starts to leak or has (partially) occluded. We don't always know why this happens. To gain more insight into this, the studies in this thesis have looked at potential changes in the shape of the stent in the years after surgery. This is done with CT scans that are linked to the heartbeat, so that the movement of the stent during the heartbeat could also be measured and compared at different times after surgery. This research has led to new advice for vascular surgeons about the placement of the stents and the follow-up of patients after surgery. In addition, the outcomes of these studies help the manufacturers improving the stents, since the understanding of the changes in the stent are better understood.