Background: The objective of the study was to evaluate the impact of initial aneurysmal sac reduction after endovascular aneurysm repair on the evolution of aneurysmal sac over follow-up.
Methods: A retrospective cohort study was made of patients subjected to elective treatment between January 2005 and December 2014, with a minimum follow-up of 18 months. An analysis was made of the evolution of the aneurysmal sac according to its condition one year after surgery, defining of two groups: A (sac reduction) and B (stable sac). Follow-up by computed tomography (CT) angiography was made after one month and then every 6 months or annually, depending on the presence of endoleak.
Results: A total of 128 patients were included. Fifty-one patients (39.8%) showed a significant decrease in diameter during the first year (group A), whereas 77 patients (60.2%) showed no initial decrease (group B). Preoperative CT angiography showed the patients in group A to have larger aneurysms (63.5 mm vs. 59.25; P = 0.048), a greater presence of posterior thrombus (68.6% vs. 30.7%; P < 0.001), and fewer patent lumbar vessels (56.9% vs. 83.1%; P = 0.001). The prevalence of endoleak at some point during follow-up was lower in group A (31.4% vs. 74% in group B; P < 0.001), and 100% of all aneurysmal growths were associated to the presence of endoleak. After 5 years, significant differences were observed in the growth-free rate (96.9% in group A vs. 85.2% in group B; hazard ratio [HR] 4.8 [1.1-21.4; P = 0.036]) and in the reintervention-free rate (95,7% vs. 84.6%; HR 6.6 [0.8-52.4; P = 0.07]). No reoperation in group A was due to type II endoleak.
Conclusions: The aneurysmal sac can be expected to take a favorable course in those cases characterized by initial aneurysmal sac reduction. These findings may imply a change in the follow-up protocol, even in cases with type II endoleak.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.avsg.2019.09.006 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Case Report: Gutter endoleak embolization in a patient with bilateral common iliac artery aneurysms treated with sandwich parallel grafts.
Front Surg
December 2024
School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Background: Current guidelines recommend preserving at least one of the bilateral pelvic flows in patients with aortoiliac aneurysms. The sandwich parallel graft, using commercially available devices, provides a viable option for patients who fall outside the instructions for use of iliac branch devices. However, gutter endoleak remains a significant challenge.
View Article and Find Full Text PDFThe interdependent hemodynamic influence between abdominal aortic aneurysm and renal artery stenosis.
Sci Rep
December 2024
Department of Biomedical Engineering, National University of Singapore, Block E7 #06-02, 15 Kent Ridge Cres, Singapore, 119276, Singapore.
Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide with abdominal aortic aneurysm (AAA) and renal artery stenosis (RAS) standing out as significant contributors to the vascular pathology spectrum. While these conditions have traditionally been approached as distinct entities, emerging evidence suggests a compelling interdependent relationship between AAA and RAS, challenging the conventional siloed understanding. The confluence of AAA and RAS represents a complex interplay within the cardiovascular system, one that is often overlooked in clinical practice and research.
View Article and Find Full Text PDFTreatment of Paraclinoid Aneurysms With Stent-Assisted Coiling Versus Flow Diversion Techniques: A Systematic Review and Meta-Analysis.
J Craniofac Surg
December 2024
Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, P.R. China.
Background: The stent-assisted coiling (SAC) and flow-diverter stent (FDS) techniques are widely used in the endovascular treatment of paraclinoid aneurysms. This article compares the occlusion rate, periprocedural complications, and clinical outcomes of SAC and FDSs.
Methods: Between January 2010 and December 2020, a systematic search of electronic databases identified 2283 articles for screening.
Potential of D-Dimer as a Tool to Rule Out Sac Expansion in Patients With Persistent Type 2 Endoleaks After Endovascular Aneurysm Repair.
J Endovasc Ther
December 2024
Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Purpose: In managing type 2 endoleak (T2EL) following endovascular aortic aneurysm repair (EVAR), an indication for reintervention is aneurysm enlargement (AnE). A previous study found that low D-dimer levels (DDLs) at 1 year were associated with reduced AnE risk in patients with persistent T2ELs (pT2ELs). This study analyzed patients with pT2ELs to determine the correlation between DDLs at annual follow-ups and AnE and proposed a follow-up protocol incorporating DDL monitoring.
View Article and Find Full Text PDFDevelopment of a method to achieve antegrade in situ fenestration of endovascular stent grafts in abdominal aortic aneurysms.
J Vasc Surg Cases Innov Tech
February 2025
Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA.
Abdominal aortic aneurysm (AAA) is the focal dilation of the terminal aorta, which can lead to rupture if left untreated. Traditional endovascular aneurysm repair techniques are minimally invasive and pose low mortality rates compared with open surgical repair; however, endovascular aneurysm repair procedures face challenges in accommodating variations in the patient's anatomy. Complex aneurysms are defined when the sac extends past the renal arteries or has an insufficient neck landing zone to deploy a traditional endograft.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!