Reduced pulsatile wall motion of abdominal aortic aneurysms after endovascular repair

Research output: Contribution to journalArticle

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 < 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.

Details

Authors
  • Martin Malina
  • Toste Länne
  • Krassi Ivancev
  • Bengt Lindblad
  • Jan Brunkwall
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems
Original languageEnglish
Pages (from-to)624-631
JournalJournal of Vascular Surgery
Volume27
Issue number4
Publication statusPublished - 1998
Publication categoryResearch
Peer-reviewedYes

Bibliographic note

The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Medical Radiology Unit (013241410), Emergency medicine/Medicine/Surgery (013240200), Unit for Clinical Vascular Disease Research (013242410)