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Suitability of the Aortic Neck Anatomy for Endovascular Aneurysm Repair in Korean Patients with Abdominal Aortic Aneurysm

PURPOSE: To evaluate the aortic neck anatomy in Korean patients with abdominal aortic aneurysms (AAAs). MATERIALS AND METHODS: We examined computed tomography scans of 343 patients with AAAs (≥5.5 cm for men or ≥5 cm for women) between 2009 and 2018. Eligibility of neck anatomy for endovascular aneu...

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Autores principales: Hwang, Deokbi, Kim, Jihye, Kim, Hyung-Kee, Huh, Seung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Vascular Surgery 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333089/
https://www.ncbi.nlm.nih.gov/pubmed/32611839
http://dx.doi.org/10.5758/vsi.200016
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author Hwang, Deokbi
Kim, Jihye
Kim, Hyung-Kee
Huh, Seung
author_facet Hwang, Deokbi
Kim, Jihye
Kim, Hyung-Kee
Huh, Seung
author_sort Hwang, Deokbi
collection PubMed
description PURPOSE: To evaluate the aortic neck anatomy in Korean patients with abdominal aortic aneurysms (AAAs). MATERIALS AND METHODS: We examined computed tomography scans of 343 patients with AAAs (≥5.5 cm for men or ≥5 cm for women) between 2009 and 2018. Eligibility of neck anatomy for endovascular aneurysm repair (EVAR) was assessed with the standard instructions for use (IFU) (length ≥15 mm, suprarenal angulation (SRA) ≤45°, infrarenal angulation (IRA) ≤60°, and diameter 18-32 mm) and the extended IFU (length ≥10 mm, SRA ≤60°, IRA ≤75°, and diameter 17-32 mm). RESULTS: There were 71 women (20.7%), and 61 patients (17.8%) with rupture. Women had smaller neck diameters (21.3 vs. 23.4 mm, P<0.001 for proximal neck; 22.2 vs. 24.5 mm, P<0.001 for distal neck), and higher angulations (51.5° vs. 37.8°, P<0.001 for SRA; 77.7° vs. 57.0°, P<0.001 for IRA) than men. However, the neck length was not significantly different. Patients with ruptured AAAs had shorter neck lengths (21.0 vs. 26.8 mm, P=0.005) than those with intact AAAs. However, the neck diameters and angulations were not significantly different. EVAR eligibility for standard and extended IFUs was found in 37.5% and 55.1% of men, and 11.3% and 25.4% of women (P<0.001 for both IFUs); neck anatomy was eligible in 34.0% of intact AAAs and 23.0% of ruptured AAAs (P=0.098). CONCLUSION: A significant proportion of the Korean patients did not meet the IFU for EVAR, mainly due to the angulated neck. Women, and patients with ruptured AAAs, were less likely to meet the IFU criteria.
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spelling pubmed-73330892020-07-15 Suitability of the Aortic Neck Anatomy for Endovascular Aneurysm Repair in Korean Patients with Abdominal Aortic Aneurysm Hwang, Deokbi Kim, Jihye Kim, Hyung-Kee Huh, Seung Vasc Specialist Int Original Article PURPOSE: To evaluate the aortic neck anatomy in Korean patients with abdominal aortic aneurysms (AAAs). MATERIALS AND METHODS: We examined computed tomography scans of 343 patients with AAAs (≥5.5 cm for men or ≥5 cm for women) between 2009 and 2018. Eligibility of neck anatomy for endovascular aneurysm repair (EVAR) was assessed with the standard instructions for use (IFU) (length ≥15 mm, suprarenal angulation (SRA) ≤45°, infrarenal angulation (IRA) ≤60°, and diameter 18-32 mm) and the extended IFU (length ≥10 mm, SRA ≤60°, IRA ≤75°, and diameter 17-32 mm). RESULTS: There were 71 women (20.7%), and 61 patients (17.8%) with rupture. Women had smaller neck diameters (21.3 vs. 23.4 mm, P<0.001 for proximal neck; 22.2 vs. 24.5 mm, P<0.001 for distal neck), and higher angulations (51.5° vs. 37.8°, P<0.001 for SRA; 77.7° vs. 57.0°, P<0.001 for IRA) than men. However, the neck length was not significantly different. Patients with ruptured AAAs had shorter neck lengths (21.0 vs. 26.8 mm, P=0.005) than those with intact AAAs. However, the neck diameters and angulations were not significantly different. EVAR eligibility for standard and extended IFUs was found in 37.5% and 55.1% of men, and 11.3% and 25.4% of women (P<0.001 for both IFUs); neck anatomy was eligible in 34.0% of intact AAAs and 23.0% of ruptured AAAs (P=0.098). CONCLUSION: A significant proportion of the Korean patients did not meet the IFU for EVAR, mainly due to the angulated neck. Women, and patients with ruptured AAAs, were less likely to meet the IFU criteria. The Korean Society for Vascular Surgery 2020-06-30 2020-06-30 /pmc/articles/PMC7333089/ /pubmed/32611839 http://dx.doi.org/10.5758/vsi.200016 Text en Copyright © 2020, The Korean Society for Vascular Surgery This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hwang, Deokbi
Kim, Jihye
Kim, Hyung-Kee
Huh, Seung
Suitability of the Aortic Neck Anatomy for Endovascular Aneurysm Repair in Korean Patients with Abdominal Aortic Aneurysm
title Suitability of the Aortic Neck Anatomy for Endovascular Aneurysm Repair in Korean Patients with Abdominal Aortic Aneurysm
title_full Suitability of the Aortic Neck Anatomy for Endovascular Aneurysm Repair in Korean Patients with Abdominal Aortic Aneurysm
title_fullStr Suitability of the Aortic Neck Anatomy for Endovascular Aneurysm Repair in Korean Patients with Abdominal Aortic Aneurysm
title_full_unstemmed Suitability of the Aortic Neck Anatomy for Endovascular Aneurysm Repair in Korean Patients with Abdominal Aortic Aneurysm
title_short Suitability of the Aortic Neck Anatomy for Endovascular Aneurysm Repair in Korean Patients with Abdominal Aortic Aneurysm
title_sort suitability of the aortic neck anatomy for endovascular aneurysm repair in korean patients with abdominal aortic aneurysm
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333089/
https://www.ncbi.nlm.nih.gov/pubmed/32611839
http://dx.doi.org/10.5758/vsi.200016
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