| Intra-aneurysm sac pressure in patients with unchanged AAA diameter after EVAR. | |
| | |
MedLine Citation:
|
PMID: 19906545 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To study intra-aneurysm sac pressure and subsequent abdominal aortic aneurysm (AAA) diameter changes in patients without endoleaks that remain unchanged in AAA diameter more than 1 year after endovascular aneurysm repair (EVAR). METHODS: A total of 23 patients underwent direct intra-aneurysm sac pressure (DISP) measurements 16 months (IQR: 14-35 months) after EVAR. Tip-pressure sensors were used through translumbar AAA puncture. Mean pressure index (MPI) was calculated as the percentage of mean intra-aneurysm pressure relative to the simultaneous mean intra-aortic pressure. Aneurysm expansion or shrinkage was assumed whenever the diameter change was > or =5mm. Values are presented as median and interquartile range. RESULTS: In 18 patients, no fluid was obtained upon AAA puncture (group A). In five patients, fluid was obtained (group B). In group A, follow-up continued for 29 months (IQR: 15-35 months) after DISP; five AAAs shrank, 10 remained unchanged and three expanded (MPIs of 26% (IQR: 18-42%), 28% (IQR: 20-48%) and 63% (IQR: 47-83%) and intra-sac pulse pressures of 3 mmHg (IQR: 0-5 mmHg), 4 mmHg (IQR: 2-8mm Hg) and 12 mmHg (IQR: 6-20 mmHg), respectively, for the three subgroups). MPI and intra-sac pulse pressures were higher in AAAs that subsequently expanded (P=0.073 and 0.017, respectively). MPI and pulse pressure correlated with total diameter change (r=0.49, P=0.039 and r =0.39, P=0.109, respectively). Pulse pressure had a greater influence than MPI on diameter change (R(2)=0.346, P=0.041, beta standardised coefficient of 0.121 for MPI and 0.502 for pulse pressure). Similar results with stronger, and significant correlation to pulse pressure were obtained when relative diameter changes were used (r=0.55, P=0.017). In group B, MPI and AAA pulse pressure were 32% (IQR: 18-37%) and 1 mmHg (IQR: 0-6 mmHg), respectively. After 36 months (IQR: 21-38 months), one AAA shrank, three continued unchanged while one expanded. CONCLUSIONS: AAAs without endoleak and unchanged diameter more than 1 year after EVAR will often continue unchanged. Expansion can eventually occur in the absence of intra-sac fluid accumulation and is associated with higher and more pulsatile intra-sac pressure. However, in patients with intra-sac fluid, expansion can occur with low intra-sac pressures. |
| | |
Authors:
|
N V Dias; K Ivancev; T K?lbel; T Resch; M Malina; B Sonesson |
Related Documents
:
|
843545 - Reactivity of neonatal canine aortic strips. 9796675 - Elastic response of human iliac arteries in-vitro to balloon angioplasty using high-res... 2180265 - Balloon angioplasty for aortic recoarctation: results of valvuloplasty and angioplasty ... 15604135 - Echocardiographic assessment of aortic elastic properties with automated border detecti... 8113325 - Extracellular volume fraction and diffusion characteristics during progressive ischemia... 12206855 - Effect of the vasopressin receptor antagonist conivaptan in rats with heart failure fol... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-11-10 |
Journal Detail:
|
Title: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Volume: 39 ISSN: 1532-2165 ISO Abbreviation: Eur J Vasc Endovasc Surg Publication Date: 2010 Jan |
Date Detail:
|
Created Date: 2010-02-03 Completed Date: 2010-02-25 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9512728 Medline TA: Eur J Vasc Endovasc Surg Country: England |
Other Details:
|
Languages: eng Pagination: 35-41 Citation Subset: IM |
Copyright Information:
|
Copyright 2009 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
|
Vascular Center Malm?-Lund, Malm? University Hospital, Malm?, Sweden. nuno.dias@med.lu.se |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Aortic Aneurysm, Abdominal / physiopathology, radiography, surgery* Aortography / methods Blood Pressure Blood Vessel Prosthesis Blood Vessel Prosthesis Implantation* / instrumentation Female Humans Male Pressure Prosthesis Design Pulsatile Flow Stents Time Factors Tomography, X-Ray Computed Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Closed Tibial Fracture Associated with Laceration of Tibialis Anterior Tendon.
Next Document: Endovascular Treatment of Profunda Femoris Artery Obstructive Disease: Nonsense or Useful Tool in Se...