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Supra-and Infra-Renal Aortic Neck Diameter Increase after Endovascular Repair of a Ruptured Abdominal Aortic Aneurysm

van der Riet, Claire ; Schuurmann, Richte C.L. ; Karelis, Angelos LU orcid ; Suludere, Mehmet A. ; van Harten, Meike J. ; Sonesson, Björn LU ; Dias, Nuno V. LU orcid ; de Vries, Jean Paul P.M. and Dijkstra, Martijn L. (2022) In Journal of Clinical Medicine 11(5).
Abstract

Hypovolemia-induced hypotension may lead to an aortic diameter decrease in patients with a ruptured abdominal aortic aneurysm (rAAA). This study investigates the changes in supra-and infra-renal aortic neck diameters before and after endovascular aortic aneurysm repair (EVAR) for rAAA and the possible association with endograft apposition. A retrospective cohort study was conducted including 74 patients treated between 2010 and 2019 in two large European vascular centers. Outer-to-outer wall diameters were measured at +40, +10, 0, −10, and −20 mm relative to the lowest renal artery baseline on the last pre-and first post-EVAR computed tomography angiography (CTA) scan in a vascular workstation. Endograft apposition was determined on the... (More)

Hypovolemia-induced hypotension may lead to an aortic diameter decrease in patients with a ruptured abdominal aortic aneurysm (rAAA). This study investigates the changes in supra-and infra-renal aortic neck diameters before and after endovascular aortic aneurysm repair (EVAR) for rAAA and the possible association with endograft apposition. A retrospective cohort study was conducted including 74 patients treated between 2010 and 2019 in two large European vascular centers. Outer-to-outer wall diameters were measured at +40, +10, 0, −10, and −20 mm relative to the lowest renal artery baseline on the last pre-and first post-EVAR computed tomography angiography (CTA) scan in a vascular workstation. Endograft apposition was determined on the first post-EVAR CTA scan. The post-operative diameter was significantly (p < 0.001) larger than the preoperative diameter at all aortic levels. The aortic diameter at +40 mm (supra-renal) and −10 mm (infra-renal) increased by 6.2 ± 7.3% and 12.6 ± 9.8%, respectively. The aortic diameter at +40 mm increased significantly more in patients with low preoperative systolic blood pressure (<90 mmHg; p = 0.005). A shorter apposition length was associated with a higher aortic diameter increase (R = −0.255; p = 0.032). Hypovolemic-induced hypotension results in a significant decrease in the aortic diameter in patients with an rAAA, which should be taken into account when oversizing the endograft.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Abdominal aortic aneurysm, Endovascular procedures, Hypotension, Hypovolemic shock, Ruptured aneurysm
in
Journal of Clinical Medicine
volume
11
issue
5
article number
1203
publisher
MDPI AG
external identifiers
  • pmid:35268292
  • scopus:85125085356
ISSN
2077-0383
DOI
10.3390/jcm11051203
language
English
LU publication?
yes
id
5d1f438c-1125-44ce-aef0-1c23fd28d64d
date added to LUP
2022-04-29 14:52:08
date last changed
2024-03-26 20:28:37
@article{5d1f438c-1125-44ce-aef0-1c23fd28d64d,
  abstract     = {{<p>Hypovolemia-induced hypotension may lead to an aortic diameter decrease in patients with a ruptured abdominal aortic aneurysm (rAAA). This study investigates the changes in supra-and infra-renal aortic neck diameters before and after endovascular aortic aneurysm repair (EVAR) for rAAA and the possible association with endograft apposition. A retrospective cohort study was conducted including 74 patients treated between 2010 and 2019 in two large European vascular centers. Outer-to-outer wall diameters were measured at +40, +10, 0, −10, and −20 mm relative to the lowest renal artery baseline on the last pre-and first post-EVAR computed tomography angiography (CTA) scan in a vascular workstation. Endograft apposition was determined on the first post-EVAR CTA scan. The post-operative diameter was significantly (p &lt; 0.001) larger than the preoperative diameter at all aortic levels. The aortic diameter at +40 mm (supra-renal) and −10 mm (infra-renal) increased by 6.2 ± 7.3% and 12.6 ± 9.8%, respectively. The aortic diameter at +40 mm increased significantly more in patients with low preoperative systolic blood pressure (&lt;90 mmHg; p = 0.005). A shorter apposition length was associated with a higher aortic diameter increase (R = −0.255; p = 0.032). Hypovolemic-induced hypotension results in a significant decrease in the aortic diameter in patients with an rAAA, which should be taken into account when oversizing the endograft.</p>}},
  author       = {{van der Riet, Claire and Schuurmann, Richte C.L. and Karelis, Angelos and Suludere, Mehmet A. and van Harten, Meike J. and Sonesson, Björn and Dias, Nuno V. and de Vries, Jean Paul P.M. and Dijkstra, Martijn L.}},
  issn         = {{2077-0383}},
  keywords     = {{Abdominal aortic aneurysm; Endovascular procedures; Hypotension; Hypovolemic shock; Ruptured aneurysm}},
  language     = {{eng}},
  number       = {{5}},
  publisher    = {{MDPI AG}},
  series       = {{Journal of Clinical Medicine}},
  title        = {{Supra-and Infra-Renal Aortic Neck Diameter Increase after Endovascular Repair of a Ruptured Abdominal Aortic Aneurysm}},
  url          = {{http://dx.doi.org/10.3390/jcm11051203}},
  doi          = {{10.3390/jcm11051203}},
  volume       = {{11}},
  year         = {{2022}},
}