Abstract

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°/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.

Original languageEnglish (US)
Pages (from-to)2249-2256
Number of pages8
JournalJournal of Biomechanics
Volume47
Issue number10
DOIs
StatePublished - Jul 18 2014

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Axial compression
Torsional stress
Extremities
Arteries
Popliteal Artery
Knee
Tunica Intima
Elastin
Adventitia
Histology
Fluoroscopy
Stainless Steel
Femoral Artery
Image segmentation
Lower Extremity
Stainless steel
Staining and Labeling
Imaging techniques
Fibers

Keywords

  • Bending
  • Biomechanics
  • Compression
  • Femoropopliteal artery
  • Flexion
  • Human
  • Intra-arterial markers
  • Peripheral artery disease
  • Torsion

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Biomedical Engineering
  • Rehabilitation

Cite this

@article{deb56db8505e42289d95ad0bacfb694d,
title = "Three-dimensional bending, torsion and axial compression of the femoropopliteal artery during limb flexion",
abstract = "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°/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.",
keywords = "Bending, Biomechanics, Compression, Femoropopliteal artery, Flexion, Human, Intra-arterial markers, Peripheral artery disease, Torsion",
author = "Mactaggart, {Jason N} and Phillips, {Nicholas Y.} and Lomneth, {Carol S.} and Pipinos, {Iraklis I} and Robert Bowen and Baxter, {Bernard Timothy} and Johanning, {Jason M} and Longo, {G Matthew} and Desyatova, {Anastasia S.} and Moulton, {Michael J} and Yuris Dzenis and Alexey Kamenskiy",
year = "2014",
month = "7",
day = "18",
doi = "10.1016/j.jbiomech.2014.04.053",
language = "English (US)",
volume = "47",
pages = "2249--2256",
journal = "Journal of Biomechanics",
issn = "0021-9290",
publisher = "Elsevier Limited",
number = "10",

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TY - JOUR

T1 - Three-dimensional bending, torsion and axial compression of the femoropopliteal artery during limb flexion

AU - Mactaggart, Jason N

AU - Phillips, Nicholas Y.

AU - Lomneth, Carol S.

AU - Pipinos, Iraklis I

AU - Bowen, Robert

AU - Baxter, Bernard Timothy

AU - Johanning, Jason M

AU - Longo, G Matthew

AU - Desyatova, Anastasia S.

AU - Moulton, Michael J

AU - Dzenis, Yuris

AU - Kamenskiy, Alexey

PY - 2014/7/18

Y1 - 2014/7/18

N2 - 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°/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.

AB - 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°/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.

KW - Bending

KW - Biomechanics

KW - Compression

KW - Femoropopliteal artery

KW - Flexion

KW - Human

KW - Intra-arterial markers

KW - Peripheral artery disease

KW - Torsion

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