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- Title
Supra- and Infra-Renal Aortic Neck Diameter Increase after Endovascular Repair of a Ruptured Abdominal Aortic Aneurysm.
- Authors
van der Riet, Claire; Schuurmann, Richte C. L.; Karelis, Angelos; Suludere, Mehmet A.; van Harten, Meike J.; Sonesson, Björn; Dias, Nuno V.; de Vries, Jean-Paul P. M.; Dijkstra, Martijn L.
- 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 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.
- Subjects
AORTIC rupture; ABDOMINAL aortic aneurysms; ENDOVASCULAR surgery; AORTA; SYSTOLIC blood pressure; KIDNEY transplantation
- Publication
Journal of Clinical Medicine, 2022, Vol 11, Issue 5, p1203
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm11051203