Presentation Title

Assessment of microstructural damage to human femoropopliteal arteries during and after balloon angioplasty

Presenter Information

Pauline StruczewskaFollow

Advisor Information

Dr. Alexey Kamenskiy

Location

MBSC Omaha Room 304 - G

Presentation Type

Oral Presentation

Start Date

4-3-2022 10:45 AM

End Date

4-3-2022 12:00 PM

Abstract

Peripheral artery disease (PAD) often refers to the atherosclerotic obstruction of the femoropopliteal artery (FPA) in the lower extremities. It is associated with significant cardiovascular mortality and morbidity and is often treated with percutaneous balloon angioplasty (PBA). Results of PBA are often unsatisfactory in severely calcified lesions where it produces minimal luminal gains, residual stenosis, and flow-limiting arterial dissections that lead to treatment failure and reinterventions. To better understand the characteristics of calcified lesions that complicate PBA, we have developed a novel microstructural assessment method that involves X-ray microtomographic imaging of human arteries before, during, and after balloon inflation. The artery is mounted on a custom-made fixture with a balloon access port and is inflated with low-density foam to avoid artifacts. Scans of the pressurized artery are obtained using the EasyTomS system, and Mimics v24 and 3-Matic v16 are used to compare 3D models of the FPA before, during, and after PBA. Endpoints of the analysis include luminal area again, wall thickness as a function of artery length, changes to the calcification patterns, and the presence of arterial dissection as a result of the angioplasty procedure. The developed methodology can be used to analyze the effects of PBA on complex FPA lesions and identify plaque features that result in dissections, poor luminal gains, and arterial damage. These data will allow better patient selection and may reduce PBA complications, thereby improving clinical outcomes for PAD patients with claudication and critical limb ischemia.

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Mar 4th, 10:45 AM Mar 4th, 12:00 PM

Assessment of microstructural damage to human femoropopliteal arteries during and after balloon angioplasty

MBSC Omaha Room 304 - G

Peripheral artery disease (PAD) often refers to the atherosclerotic obstruction of the femoropopliteal artery (FPA) in the lower extremities. It is associated with significant cardiovascular mortality and morbidity and is often treated with percutaneous balloon angioplasty (PBA). Results of PBA are often unsatisfactory in severely calcified lesions where it produces minimal luminal gains, residual stenosis, and flow-limiting arterial dissections that lead to treatment failure and reinterventions. To better understand the characteristics of calcified lesions that complicate PBA, we have developed a novel microstructural assessment method that involves X-ray microtomographic imaging of human arteries before, during, and after balloon inflation. The artery is mounted on a custom-made fixture with a balloon access port and is inflated with low-density foam to avoid artifacts. Scans of the pressurized artery are obtained using the EasyTomS system, and Mimics v24 and 3-Matic v16 are used to compare 3D models of the FPA before, during, and after PBA. Endpoints of the analysis include luminal area again, wall thickness as a function of artery length, changes to the calcification patterns, and the presence of arterial dissection as a result of the angioplasty procedure. The developed methodology can be used to analyze the effects of PBA on complex FPA lesions and identify plaque features that result in dissections, poor luminal gains, and arterial damage. These data will allow better patient selection and may reduce PBA complications, thereby improving clinical outcomes for PAD patients with claudication and critical limb ischemia.