Document Detail

Intraoperative sac pressure measurement during endovascular abdominal aortic aneurysm repair.
MedLine Citation:
PMID:  20703478     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Intraoperative sac pressure was measured during endovascular abdominal aortic aneurysm repair (EVAR) to evaluate the clinical significance of sac pressure measurement.
METHODS: A microcatheter was placed in an aneurysm sac from the contralateral femoral artery, and sac pressure was measured during EVAR procedures in 47 patients. Aortic blood pressure was measured as a control by a catheter from the left brachial artery.
RESULTS: The systolic sac pressure index (SPI) was 0.87 +/- 0.10 after main-body deployment, 0.63 +/- 0.12 after leg deployment (P < 0.01), and 0.56 +/- 0.12 after completion of the procedure (P < 0.01). Pulse pressure was 55 +/- 21 mmHg, 23 +/- 15 mmHg (P < 0.01), and 16 +/- 12 mmHg (P < 0.01), respectively. SPI showed no significant differences between the Zenith and Excluder stent grafts (0.56 +/- 0.13 vs. 0.54 +/- 0.10, NS). Type I endoleak was found in seven patients (15%), and the SPI decreased from 0.62 +/- 0.10 to 0.55 +/- 0.10 (P = 0.10) after fixing procedures. Type II endoleak was found in 12 patients (26%) by completion angiography. The SPI showed no difference between type II endoleak positive and negative (0.58 +/- 0.12 vs. 0.55 +/- 0.12, NS). There were no significant differences between the final SPI of abdominal aortic aneurysms in which the diameter decreased in the follow-up and that of abdominal aortic aneurysms in which the diameter did not change (0.53 +/- 0.12 vs. 0.57 +/- 0.12, NS).
CONCLUSIONS: Sac pressure measurement was useful for instant hemodynamic evaluation of the EVAR procedure, especially in type I endoleaks. However, on the basis of this small study, the SPI cannot be used to reliably predict sac growth or regression.
Hiroyuki Ishibashi; Tsuneo Ishiguchi; Takashi Ohta; Ikuo Sugimoto; Hirohide Iwata; Tetsuya Yamada; Masao Tadakoshi; Noriyuki Hida; Yuki Orimoto; Seiji Kamei
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Publication Detail:
Type:  Journal Article     Date:  2010-08-12
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  33     ISSN:  1432-086X     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-07     Completed Date:  2011-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  939-42     Citation Subset:  IM    
Department of Vascular Surgery, Aichi Medical University Hospital, Nagakute, Aichi, Japan.
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MeSH Terms
Angiography / methods
Angioplasty / instrumentation,  methods*
Aortic Aneurysm, Abdominal / radiography,  surgery*
Blood Pressure Determination
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation / adverse effects,  methods*
Cohort Studies
Endoleak / epidemiology,  radiography*
Follow-Up Studies
Intraoperative Care / methods
Middle Aged
Postoperative Complications / epidemiology,  physiopathology
Preoperative Care / methods
Prospective Studies
Prosthesis Design
Risk Assessment
Time Factors
Transducers, Pressure
Treatment Outcome

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