# Volumetric Analysis of Aortic Changes after TEVAR Using Three-Dimensional Virtual Modeling
## 3 Results  
A total of 6 of 30 patients were excluded from the study due to insufficient quality of the diagnostic imaging (e.g., the origin of the celiac trunk was not visible in the thoracic CTA scan). Therefore, a total of 24 patients were included; their demographics and clinical data are reported in Table 1. The patients were predominately males (75%), with a mean age of 68 \(\pm\) 10 years. Laboratory data and, in particular, inflammatory markers were evaluated at discharge and 12 months after TEVAR; the results are reported in Table 1. Only the D-dimer levels were increased at follow-up, while the other evaluated inflammatory markers were not significantly different. The mean clinical follow-up time after TEVAR was 55.3 \(\pm\) 26.6 months. The TEVAR-related data, events, and complications during the total follow-up time are reported in Table 2. A total of 39 stent grafts were implanted, with an average of 1.6 for each TEVAR. The most frequently implanted stent graft was the Medtronic Valiant Captivia (69%); the other used stent grafts were the Bolton Relay (13%), the Gore TAG (10%), the Cook Zenith (5%), and Jotec custom stent grafts (2.5%). During the follow-up period, 12 patients (50%) had an endoleak, 5 of which were limited to a type II endoleak, while stent graft migration was reported in 6 patients (Figure 3). A total of eight (33%) patients experienced TEVAR-related complications: seven patients underwent re-TEVAR, two of them acquiring another re-TEVAR in the following months. Re-TEVAR was required for degenerative changes to the distal aortic neck with type Ib endoleak in seven cases (77%), for proximal aortic neck degeneration with type Ia endoleak in one case (11%), and for both proximal and distal aortic neck degeneration in one case (11%). Four patients died during the total follow-up time, with only one stent-related death. At 14 months after TEVAR, after progressive dilatation of the proximal landing zone, the stent graft slightly migrated downward, creating a type Ia endoleak. As the DTAA increased over time, the patient underwent surgical intervention with ascending aorta and aortic arch replacement. The patient died some days later for bowel infarction and renal ischemia caused by systemic hypotension. \begin{table}
\begin{tabular}{l c} \hline
**Patients Characteristics** & \(n\) = 24 \\ \hline Demographic Data & \\ \hline Males (\%) & 18 (75\%) \\ Age, years (mean \(\pm\) SD) & 68.2 \(\pm\) 10.3 \\ \hline Clinical Data & \\ \hline Hypertension & 18 (75\%) \\ Smoking & 8 (33\%) \\ Diabetes mellitus & 2 (8\%) \\ Dyslipidemia & 6 (25\%) \\ CAD & 7 (29\%) \\ COPD & 4 (17\%) \\ CKD & 3 (13\%) \\ \hline Laboratory Data (Mean \(\pm\) SD) & At Discharge & At 12 Months & \(p\) \\ \hline CRP, mg/dL & 2.7 \(\pm\) 4.7 & 1.3 \(\pm\) 1.8 & n.s. \\ IL-6, pg/mL & 7.1 \(\pm\) 6.4 & 31.5 \(\pm\) 101.6 & n.s. \\ ESR, mm/h & 23.2 \(\pm\) 15.8 & 26.5 \(\pm\) 13.8 & n.s. \\ D-dimer, ug/L & 5.8 \(\pm\) 4.0 & 10.6 \(\pm\) 9.6 & 0.027 \\ \hline \end{tabular}
\end{table} 
Table 1: Demographic, clinical, and laboratory data of the patients included in our study. CAD, coronary artery disease; COPD, chronic obstructive pulmonary disease; CKD, chronic kidney disease; CRP, c-reactive protein; ESR, erythrocyte sedimentation rate. n.s. = not significant.