Document Detail


Morphometric analysis of anatomic variables affecting endovascular stent design in patients undergoing elective and emergency repair of endovascular abdominal aortic aneurysm.
MedLine Citation:
PMID:  20100409     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Our objective was to identify morphologic trends in elective and emergency endovascular aneurysm repair (EVAR). This work will inform hospitals with endovascular programs about the diameters and lengths of endostents that should be available to efficiently care for patients with these conditions. METHODS: We performed a retrospective review of patients undergoing elective (n = 127) and emergency (n = 17) EVAR. Using computed tomography and 3-dimensional reconstructions, we evaluated the following: diameters of the aneurysm (D3), the aorta at the superior mesenteric (D1) and renal (D2a,b,c; 3 levels) levels, the iliac arteries (D5a,b; right and left) and the aortic bifurcation (D4); lengths from the lowest renal artery to the distal aspect of the aortic neck (H1), to the aortic bifurcation (H3), to the right and left iliac bifurcations (H4a,b); and angles of the origin of the common iliac arteries on the transverse plane (A1). We used descriptive statistics of trends within groups and independent sample t tests. RESULTS: In elective and emergency aneurysm repair, D2max (26, standard deviation [SD] 3, mm v. 30.7 [SD 3] mm), D5a (16 [SD 4.7] mm v. 19.3 [SD 5] mm), D5b (15.3 [SD 4] mm v. 18.1 [SD 3.6] mm), H1 (25.6 [SD 8.6] mm v. 18 [SD 2] mm), H4a (173 [SD 22] mm v. 189.5 [SD 22] mm) and H4b (174 [SD 25] mm v. 190 [SD 14] mm) were significantly different between the 2 groups (p = 0.001, p = 0.006, p = 0.007, p < 0.001, p = 0.05 and p = 0.01, respectively). H3 (118 [SD 17] mm v. 121.5 [SD 13.5] mm) was not significantly different (p = 0.40). In elective patients, A1 identified the right common iliac more frequently anterior relative to the left common iliac (mean 23 degrees , SD 16 degrees). CONCLUSION: Significant anatomic differences between elective and emergency patients will require hospitals to stock separate endovascular devices to treat abdominal aortic aneurysms in both groups.
Authors:
Michael Kilian; Wilfred Dang; Claudio S Cinà
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Canadian journal of surgery. Journal canadien de chirurgie     Volume:  53     ISSN:  1488-2310     ISO Abbreviation:  Can J Surg     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-26     Completed Date:  2010-02-23     Revised Date:  2010-09-28    
Medline Journal Info:
Nlm Unique ID:  0372715     Medline TA:  Can J Surg     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  25-31     Citation Subset:  IM    
Affiliation:
The Division of Vascular Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ont.
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MeSH Terms
Descriptor/Qualifier:
Aorta, Abdominal / pathology*,  radiography
Aortic Aneurysm, Abdominal / pathology*,  surgery*
Blood Vessel Prosthesis Implantation
Emergency Treatment
Humans
Iliac Artery / pathology*,  radiography
Prosthesis Design*
Prosthesis Fitting
Retrospective Studies
Stents
Surgical Procedures, Elective
Tomography, X-Ray Computed
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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