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Reduced pulsatile wall motion of abdominal aortic aneurysms after endovascular repair

Malina, Martin LU ; Länne, Toste; Ivancev, Krassi LU ; Lindblad, Bengt LU and Brunkwall, Jan (1998) In Journal of Vascular Surgery 27(4). p.624-631
Abstract
PURPOSE: The reduced size of abdominal aortic aneurysms (AAAs) after endovascular repair suggests lowered intraaneurysmal pressure. In the presence of endoleaks, the size is not decreased. Although postoperative intraaneurysmal pressure is difficult to record, the pulsatile wall motion (PWM) of aneurysms can be measured noninvasively. The aim of this study was to assess the PWM of AAAs before and after endovascular repair and to relate the change in the PWM to aneurysmal size and presence of endoleaks. METHODS: Forty-seven patients underwent endovascular repair of an AAA. The aneurysm diameter and PWM were measured with the use of ultrasonic echo-tracking scans preoperatively; at 1, 3, and 6 months; and thereafter biannually. Fifteen... (More)
PURPOSE: The reduced size of abdominal aortic aneurysms (AAAs) after endovascular repair suggests lowered intraaneurysmal pressure. In the presence of endoleaks, the size is not decreased. Although postoperative intraaneurysmal pressure is difficult to record, the pulsatile wall motion (PWM) of aneurysms can be measured noninvasively. The aim of this study was to assess the PWM of AAAs before and after endovascular repair and to relate the change in the PWM to aneurysmal size and presence of endoleaks. METHODS: Forty-seven patients underwent endovascular repair of an AAA. The aneurysm diameter and PWM were measured with the use of ultrasonic echo-tracking scans preoperatively; at 1, 3, and 6 months; and thereafter biannually. Fifteen aneurysms developed endoleaks, whereas 32 were completely excluded. The leaks were characterized with the use of computed tomographic scanning and angiography. Median follow-up was 12 months (interquartile range, 5 to 24 months). RESULTS: The preoperative PWM of the aneurysms was 1.0 mm (range, 0.8 to 1.3 mm). After complete endovascular exclusion, the PWM was 25% (range, 16% to 37%) of the preoperative value (p < 0.001), and aneurysm diameter decreased by 8 mm (range, 6 to 14 mm) (p < 0.001). After 18 months, no further diameter reduction occurred. In three patients without endoleaks but with enlarging aneurysms, the postoperative PWM showed less reduction (p < 0.05). Aneurysms with endoleaks showed no diameter decrease, and the postoperative PWM was 50% higher than that in the totally excluded cases (p < 0.01). In five patients with transient endoleaks, the PWM was reduced after leakage ceased (p < 0.05). Leaks of various sources displayed similar PWM. CONCLUSION: The size and PWM of aneurysms are reduced after endovascular repair. The diameter reduction may cease after 1.5 years. Endoleaks are associated with higher PWM than expected. Pressure may be transmitted without evidence of leaks. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Journal of Vascular Surgery
volume
27
issue
4
pages
624 - 631
publisher
Mosby
external identifiers
  • pmid:9576074
  • scopus:0031894283
ISSN
1097-6809
language
English
LU publication?
yes
id
3ee41b7b-357e-4cc6-a324-86359041ff60 (old id 1112778)
alternative location
http://www.jvascsurg.org/article/S0741-5214(98)70226-5/fulltext
date added to LUP
2008-07-11 10:55:23
date last changed
2017-04-09 04:13:18
@article{3ee41b7b-357e-4cc6-a324-86359041ff60,
  abstract     = {PURPOSE: The reduced size of abdominal aortic aneurysms (AAAs) after endovascular repair suggests lowered intraaneurysmal pressure. In the presence of endoleaks, the size is not decreased. Although postoperative intraaneurysmal pressure is difficult to record, the pulsatile wall motion (PWM) of aneurysms can be measured noninvasively. The aim of this study was to assess the PWM of AAAs before and after endovascular repair and to relate the change in the PWM to aneurysmal size and presence of endoleaks. METHODS: Forty-seven patients underwent endovascular repair of an AAA. The aneurysm diameter and PWM were measured with the use of ultrasonic echo-tracking scans preoperatively; at 1, 3, and 6 months; and thereafter biannually. Fifteen aneurysms developed endoleaks, whereas 32 were completely excluded. The leaks were characterized with the use of computed tomographic scanning and angiography. Median follow-up was 12 months (interquartile range, 5 to 24 months). RESULTS: The preoperative PWM of the aneurysms was 1.0 mm (range, 0.8 to 1.3 mm). After complete endovascular exclusion, the PWM was 25% (range, 16% to 37%) of the preoperative value (p &lt; 0.001), and aneurysm diameter decreased by 8 mm (range, 6 to 14 mm) (p &lt; 0.001). After 18 months, no further diameter reduction occurred. In three patients without endoleaks but with enlarging aneurysms, the postoperative PWM showed less reduction (p &lt; 0.05). Aneurysms with endoleaks showed no diameter decrease, and the postoperative PWM was 50% higher than that in the totally excluded cases (p &lt; 0.01). In five patients with transient endoleaks, the PWM was reduced after leakage ceased (p &lt; 0.05). Leaks of various sources displayed similar PWM. CONCLUSION: The size and PWM of aneurysms are reduced after endovascular repair. The diameter reduction may cease after 1.5 years. Endoleaks are associated with higher PWM than expected. Pressure may be transmitted without evidence of leaks.},
  author       = {Malina, Martin and Länne, Toste and Ivancev, Krassi and Lindblad, Bengt and Brunkwall, Jan},
  issn         = {1097-6809},
  language     = {eng},
  number       = {4},
  pages        = {624--631},
  publisher    = {Mosby},
  series       = {Journal of Vascular Surgery},
  title        = {Reduced pulsatile wall motion of abdominal aortic aneurysms after endovascular repair},
  volume       = {27},
  year         = {1998},
}