Document Detail


Duplex ultrasound factors predicting persistent type II endoleak and increasing AAA sac diameter after EVAR.
MedLine Citation:
PMID:  20691559     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: While the significance of type II endoleaks (T2ELs) on the long-term outcome of endovascular abdominal aneurysm repair (EVAR) to repair abdominal aortic aneurysms (AAAs) is debatable, duplex ultrasonography (DU) parameters have been suggested to be predictive of their closure or persistence. The purpose of this study was to determine which, if any, of these variables was associated with persistent T2EL or increased AAA sac diameter.
METHODS: Between 1998 and 2009, 278 patients underwent EVAR and post-operative DU surveillance during long-term follow-up (1-11 years) in our accredited non-invasive vascular laboratory by one of three experienced technologists. DU measured intra-sac flow velocity (IFV), spectral doppler waveform (SDW) patterns, post-EVAR sac diameter, and number of T2ELs.
RESULTS: T2ELs developed in 14% (38/278) of patients post-EVAR. Fourteen patients had T2ELs that resolved, and sac diameter decreased or remained the same: the average IFV was 42 cm/second; SDW patterns were monophasic in five, biphasic in seven and bidirectional in two; and multiple T2ELs were not present (0%) in any patient. Twelve patients had T2ELs that persisted, but sac diameter decreased or remained the same: the average IFV was 47 cm/second; SDW patterns were monophasic in one, biphasic in five, bidirectional in five, and undetermined in one; and multiple T2ELs were found in 17% (2) of patients. Twelve patients had T2ELs that persisted and were associated with increased sac diameter: the average IFV was 43 cm/second, SDW patterns were monophasic in one, biphasic in two, and bidirectional in nine; and multiple T2ELs were identified in 75% (9) of patients. None of the 38 patients with T2ELs treated with selective surgical or endovascular intervention for enlarging sac diameters (11/12) experienced a ruptured aneurysm.
CONCLUSION: Contrary to previous smaller reports of T2ELs and DU surveillance, parameters such as IFV did not correlate with increased post-EVAR sac diameter. The presence of multiple T2ELs and bidirectional SDW may be the strongest factors predictive of increased sac diameter.
Authors:
Brian R Beeman; Kathy Murtha; Kevin Doerr; Sandy McAfee-Bennett; Matthew J Dougherty; Keith D Calligaro
Related Documents :
17602939 - Libman-sacks endocarditis in systemic lupus erythematosus: prevalence, associations, an...
8062789 - Prosthetic heart valve.
3838679 - Mitral valve prolapse in hyperthyroidism of two different origins.
6727329 - Thromboembolism and bleeding after mitral valve replacement with porcine valves: influe...
15486379 - Follow-up of adults with coarctation of the aorta: comparison of helical ct and mri, an...
9713839 - Low frequency of clinically silent circulating emboli in patients with mitral valve pro...
1495139 - Photoplethysmography: a valuable noninvasive tool in the assessment of venous dysfunction?
1867979 - Urinary protein excretion and renal function in children with iga nephropathy.
3339129 - Elevation of total homocysteine in the serum of patients with cobalamin or folate defic...
Publication Detail:
Type:  Journal Article     Date:  2010-08-05
Journal Detail:
Title:  Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter     Volume:  52     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-05     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1147-52     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Section of Vascular Surgery, Pennsylvania Hospital, Philadelphia, PA 19106, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aortic Aneurysm, Abdominal / physiopathology,  surgery*,  ultrasonography*
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*
Endoleak / etiology,  therapy,  ultrasonography*
Endovascular Procedures / adverse effects,  instrumentation*
Hemodynamics
Humans
Pennsylvania
Predictive Value of Tests
Prosthesis Design
Prosthesis Failure*
Registries
Reoperation
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Ultrasonography, Doppler, Color
Ultrasonography, Doppler, Duplex*

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


Previous Document:  Extrahepatic portal vein aneurysm.
Next Document:  Endovascular procedures for aorto-iliac occlusive disease are associated with superior short-term cl...