Endovascular aortic repair reduces gluteal oxygenation

BACKGROUND: Provoked gluteal claudication is a known risk after endovascular aortic repair (EVAR). Lowered gluteal muscle oxygenation (S(gm)O(2)) may be demonstrated by near-infrared spectroscopy (NIRS). PURPOSE: To evaluate NIRS-determined S(gm)O(2) in EVAR patients. MATERIAL AND METHODS: NIRS-determined S(gm)O(2) was used in an observational study design (n = 17). From the ambulatory setting, seven EVAR patients were included with reported gluteal claudication from medical records. In 10 patients scheduled for EVAR, S(gm)O(2) was measured before and after the procedure. NIRS sensors were applied bilaterally on the gluteal region. Treadmill walking (12% incline, 2.4 km/h) was introduced to stress gluteal muscles. RESULTS: A reduced S(gm)O(2) with regional side difference (P < 0.05) was noted in all 10 patients following EVAR and four reported gluteal claudication. In patients with gluteal claudication (n = 7), treadmill decreased S(gm)O(2). The time to recover the S(gm)O(2) was prolonged for tissue exposed to occluded hypogastric artery (median = 512 s, range = 73–1207 s vs. median = 137, range = 0–643 s; P = 0.046). CONCLUSIONS: EVAR affects gluteal muscle oxygenation. NIRS could be used to assess whether gluteal claudication is related to lowered S(gm)O(2).