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Midterm changes in aortic aneurysm morphology after endovascular repair

Resch, Tim LU ; Ivancev, Krassi LU ; Brunkwall, J; Nirhov, Nikolaj LU ; Malina, Martin LU and Lindblad, Bengt LU (2000) In Journal of Endovascular Therapy 7(4). p.279-285
Abstract
PURPOSE: To study midterm changes in aortic aneurysm morphology after endovascular aneurysm repair. METHODS: Of 94 patients with abdominal aortic aneurysms (AAAs) treated with endografts between November 1993 and August 1998, 84 were available for follow-up. Patients were evaluated preoperatively by spiral computed tomography (CT) and aortography; in follow-up, spiral CT scanning was performed at 1, 3, and 6 months and semiannually thereafter. Measurements of the aneurysm neck diameter, maximum aneurysm diameter, and the distance from the lowermost renal artery to the aortic bifurcation were made preoperatively and in follow-up. RESULTS: Mean follow-up was 17.5 +/- 1.1 months; 56 (67%) patients were followed for 1 year and 28 (33%) for... (More)
PURPOSE: To study midterm changes in aortic aneurysm morphology after endovascular aneurysm repair. METHODS: Of 94 patients with abdominal aortic aneurysms (AAAs) treated with endografts between November 1993 and August 1998, 84 were available for follow-up. Patients were evaluated preoperatively by spiral computed tomography (CT) and aortography; in follow-up, spiral CT scanning was performed at 1, 3, and 6 months and semiannually thereafter. Measurements of the aneurysm neck diameter, maximum aneurysm diameter, and the distance from the lowermost renal artery to the aortic bifurcation were made preoperatively and in follow-up. RESULTS: Mean follow-up was 17.5 +/- 1.1 months; 56 (67%) patients were followed for 1 year and 28 (33%) for > or = 2 years. There was a median 2-mm increase (interquartile range [IQR] 0 to 3) in neck diameter at 18 months. However, a > or = 3-mm increase was seen in 18 (46%) of 39 patients examined at 18 months (median 4 mm, IQR 3 to 4, p = 0.0001). The maximum AAA diameter decreased by 9 mm (IQR 4 to 16, p = 0.0003) at 24 months, but after 18 months, no further interval decrease was seen. Aneurysms with a persistent endoleak showed either increasing or unchanged AAA diameters. There was no change in the renal artery to bifurcation distance. CONCLUSIONS: The infrarenal aortic neck appears to dilate after AAA endografting, but only in a subset of patients. Shrinkage of aneurysms after successful stent-grafting seems to stop after 18 months, implying that the only indication of late failure in the absence of endoleak might be aneurysm enlargement. Graft-related endoleaks are often associated with an increase in aneurysm diameter. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
endografts, proximal neck, AAA diameter, spiral computed tomography, endoleak
in
Journal of Endovascular Therapy
volume
7
issue
4
pages
279 - 285
publisher
International Society of Endovascular Specialists
external identifiers
  • pmid:10958291
  • scopus:0033898931
ISSN
1545-1550
DOI
10.1583/1545-1550(2000)007<0279:MCIAAM>2.3.CO;2
language
English
LU publication?
yes
id
3962669c-f207-4ef5-aefa-be45ad331cbe (old id 1116493)
date added to LUP
2008-07-01 13:48:16
date last changed
2017-02-19 03:36:56
@article{3962669c-f207-4ef5-aefa-be45ad331cbe,
  abstract     = {PURPOSE: To study midterm changes in aortic aneurysm morphology after endovascular aneurysm repair. METHODS: Of 94 patients with abdominal aortic aneurysms (AAAs) treated with endografts between November 1993 and August 1998, 84 were available for follow-up. Patients were evaluated preoperatively by spiral computed tomography (CT) and aortography; in follow-up, spiral CT scanning was performed at 1, 3, and 6 months and semiannually thereafter. Measurements of the aneurysm neck diameter, maximum aneurysm diameter, and the distance from the lowermost renal artery to the aortic bifurcation were made preoperatively and in follow-up. RESULTS: Mean follow-up was 17.5 +/- 1.1 months; 56 (67%) patients were followed for 1 year and 28 (33%) for &gt; or = 2 years. There was a median 2-mm increase (interquartile range [IQR] 0 to 3) in neck diameter at 18 months. However, a &gt; or = 3-mm increase was seen in 18 (46%) of 39 patients examined at 18 months (median 4 mm, IQR 3 to 4, p = 0.0001). The maximum AAA diameter decreased by 9 mm (IQR 4 to 16, p = 0.0003) at 24 months, but after 18 months, no further interval decrease was seen. Aneurysms with a persistent endoleak showed either increasing or unchanged AAA diameters. There was no change in the renal artery to bifurcation distance. CONCLUSIONS: The infrarenal aortic neck appears to dilate after AAA endografting, but only in a subset of patients. Shrinkage of aneurysms after successful stent-grafting seems to stop after 18 months, implying that the only indication of late failure in the absence of endoleak might be aneurysm enlargement. Graft-related endoleaks are often associated with an increase in aneurysm diameter.},
  author       = {Resch, Tim and Ivancev, Krassi and Brunkwall, J and Nirhov, Nikolaj and Malina, Martin and Lindblad, Bengt},
  issn         = {1545-1550},
  keyword      = {endografts,proximal neck,AAA diameter,spiral computed tomography,endoleak},
  language     = {eng},
  number       = {4},
  pages        = {279--285},
  publisher    = {International Society of Endovascular Specialists},
  series       = {Journal of Endovascular Therapy},
  title        = {Midterm changes in aortic aneurysm morphology after endovascular repair},
  url          = {http://dx.doi.org/10.1583/1545-1550(2000)007<0279:MCIAAM>2.3.CO;2},
  volume       = {7},
  year         = {2000},
}