Document Detail

Comparison of aortic neck dilatation after open and endovascular repair of abdominal aortic aneurysm.
MedLine Citation:
PMID:  22265796     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This study evaluated the changes of the aortic diameter at the suprarenal and infrarenal segment after open repair (OR) and endovascular repair (EVAR) of abdominal aortic aneurysms (AAAs).
METHODS: This was a retrospective analysis of all patients undergoing AAA repair between 1997 and 2008. Inclusion criteria were at least 3 months of follow-up at our institution, elective aneurysm repair, and absence of false, mycotic, or inflammatory aneurysms. For EVAR, standard computed tomography (CT) scans from follow-up were used; in the OR group, CT scans performed for unrelated nonvascular indications were used. Diameters of the aorta were measured at the first slice below the lowest renal artery and at the first slice above the highest renal artery. A 2-mm change was defined as measurable aortic neck dilatation.
RESULTS: Inclusion criteria were met by 46 patients in the OR group and 103 in the EVAR group. After a follow-up of 34.1 months (range, 5.5-131.7 months) in the OR group and 39.4 months (range, 3-108.9 months) in the EVAR group, the mean changes were 1.75 ± 3.50 mm (OR) and 0.9 ± 2.3 mm (EVAR; P = .305) in the suprarenal diameters and 0.8 ± 2.9 mm (OR) and 1.2 ± 2.5 mm (EVAR; P = .311) in the infrarenal diameters. The absolute suprarenal vs infrarenal sizes were 29.7 ± 7.1 and 28.7 ± 6.8 mm in the OR group and 28.7 ± 3.2 and 28.5 ± 3.6 mm, respectively, in the EVAR group (suprarenal, P = .749; infrarenal, P = .273). Increase of the aortic diameter >2 mm, defined as aortic neck dilatation, was found in 23 of 103 EVAR patients (22.3% ± 0.862%), and in nine of 46 OR patients (19.57% ± 0.484%; P = .870). Increase in the suprarenal change >2 mm occurred in 21 of 103 EVAR patients (20.39% ± 1.04%) and in 14 of 46 OR patients (30.4% ± 0.446%; P = .260). Reintervention rate of patients with an increase >2 mm was 31% (seven of 23) in EVAR and 11.1% (one of nine) in the OR group (P = .386).
CONCLUSIONS: The AAA groups treated with EVAR or OR demonstrated similar increases of aneurysmal neck diameters. This suggests that aortic neck dilatation may be caused by a natural progression of the disease rather than by deviating therapeutic strategies.
Alexander Oberhuber; Marcella Buecken; Martin Hoffmann; Karl-Heinz Orend; Bernd Manfred Mühling
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2012-01-21
Journal Detail:
Title:  Journal of vascular surgery     Volume:  55     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-02     Completed Date:  2012-05-30     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  929-34     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Department of Cardiothoracic and Vascular Surgery, University of Ulm, Ulm, Germany.
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MeSH Terms
Angioplasty / adverse effects,  methods*
Aorta, Abdominal / pathology,  radiography*
Aortic Aneurysm, Abdominal / radiography*,  surgery*,  therapy
Blood Vessel Prosthesis Implantation / adverse effects,  methods*
Cohort Studies
Confidence Intervals
Dilatation, Pathologic / pathology,  radiography
Follow-Up Studies
Imaging, Three-Dimensional
Middle Aged
Postoperative Period
Retrospective Studies
Statistics, Nonparametric
Tomography, X-Ray Computed / methods
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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