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ludc webb

Nuno Dias

Adjunct professor

ludc webb

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

Author

  • Claire van der Riet
  • Richte C.L. Schuurmann
  • Angelos Karelis
  • Mehmet A. Suludere
  • Meike J. van Harten
  • Björn Sonesson
  • Nuno V. Dias
  • Jean Paul P.M. de Vries
  • Martijn L. Dijkstra

Summary, in English

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.

Department/s

  • Lund University Library
  • Vascular Diseases - Clinical Research

Publishing year

2022-03

Language

English

Publication/Series

Journal of Clinical Medicine

Volume

11

Issue

5

Document type

Journal article

Publisher

MDPI AG

Topic

  • Surgery

Keywords

  • Abdominal aortic aneurysm
  • Endovascular procedures
  • Hypotension
  • Hypovolemic shock
  • Ruptured aneurysm

Status

Published

Research group

  • Vascular Diseases - Clinical Research

ISBN/ISSN/Other

  • ISSN: 2077-0383