Cargando…
Pressure gradient measurement to verify hemodynamic results of the chimney endovascular aortic repair (chEVAR) technique
PURPOSE: The use of the pressure gradient measurements to assess the renal artery flow hemodynamics after chimney endovascular aortic repair (chEVAR). METHODS: The study was a prospective analysis of 37 chEVAR procedures performend in 24 patients with perirenal aortic aneurysm. In all patients the m...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046246/ https://www.ncbi.nlm.nih.gov/pubmed/33852618 http://dx.doi.org/10.1371/journal.pone.0249549 |
_version_ | 1783678812422144000 |
---|---|
author | Milnerowicz, Artur Igor Milnerowicz, Aleksandra Bańkowski, Tomasz Protasiewicz, Marcin |
author_facet | Milnerowicz, Artur Igor Milnerowicz, Aleksandra Bańkowski, Tomasz Protasiewicz, Marcin |
author_sort | Milnerowicz, Artur Igor |
collection | PubMed |
description | PURPOSE: The use of the pressure gradient measurements to assess the renal artery flow hemodynamics after chimney endovascular aortic repair (chEVAR). METHODS: The study was a prospective analysis of 37 chEVAR procedures performend in 24 patients with perirenal aortic aneurysm. In all patients the measurement of: distal renal artery pressure (Pd), aortic pressure (Pa), Pd/Pa ratio (Pd/Pa) and mean gradient (MG) between the aorta and the distal renal artery were performed. Measurements were taken with 0.014 inch pressure wire catheter before and after the chEVAR procedure. MG greater than 9 mmHg and Pd/Pa ratio below 0.90 were considered as the measures of a significant decrease in distal pressure that limited flow in renal arteries. The 6 month follow-up computed tomographic angiography (CTA) was performed in all patients to diagnose potential endoleak presence and to verify the patency of the chimney stent-grafts. RESULTS: All procedures were successful, and no periprocedural complications were observed in any of the patients. The mean gradient values before and after the chimney implantation did not change significantly (6,2±2,0 mmHg and 6,8±2,2 mmHg, respectively). Similarly, no significant change in Pd/Pa values was noted with the value of 0.9 observed both before and after the procedure. All chimney stents were patent on the control CTA. Type Ia endoleak was found in 4 (10.8%) patients. CONCLUSIONS: The application of the described technique seems to be a safe method which allows a direct measurement of renal artery flow hemodynamics before and after chimney implantation during the chEVAR technique. The use of covered balloon expandable stents, ensures the proper blood flow in the renal arteries during the chEVAR technique. |
format | Online Article Text |
id | pubmed-8046246 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-80462462021-04-21 Pressure gradient measurement to verify hemodynamic results of the chimney endovascular aortic repair (chEVAR) technique Milnerowicz, Artur Igor Milnerowicz, Aleksandra Bańkowski, Tomasz Protasiewicz, Marcin PLoS One Research Article PURPOSE: The use of the pressure gradient measurements to assess the renal artery flow hemodynamics after chimney endovascular aortic repair (chEVAR). METHODS: The study was a prospective analysis of 37 chEVAR procedures performend in 24 patients with perirenal aortic aneurysm. In all patients the measurement of: distal renal artery pressure (Pd), aortic pressure (Pa), Pd/Pa ratio (Pd/Pa) and mean gradient (MG) between the aorta and the distal renal artery were performed. Measurements were taken with 0.014 inch pressure wire catheter before and after the chEVAR procedure. MG greater than 9 mmHg and Pd/Pa ratio below 0.90 were considered as the measures of a significant decrease in distal pressure that limited flow in renal arteries. The 6 month follow-up computed tomographic angiography (CTA) was performed in all patients to diagnose potential endoleak presence and to verify the patency of the chimney stent-grafts. RESULTS: All procedures were successful, and no periprocedural complications were observed in any of the patients. The mean gradient values before and after the chimney implantation did not change significantly (6,2±2,0 mmHg and 6,8±2,2 mmHg, respectively). Similarly, no significant change in Pd/Pa values was noted with the value of 0.9 observed both before and after the procedure. All chimney stents were patent on the control CTA. Type Ia endoleak was found in 4 (10.8%) patients. CONCLUSIONS: The application of the described technique seems to be a safe method which allows a direct measurement of renal artery flow hemodynamics before and after chimney implantation during the chEVAR technique. The use of covered balloon expandable stents, ensures the proper blood flow in the renal arteries during the chEVAR technique. Public Library of Science 2021-04-14 /pmc/articles/PMC8046246/ /pubmed/33852618 http://dx.doi.org/10.1371/journal.pone.0249549 Text en © 2021 Milnerowicz et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Milnerowicz, Artur Igor Milnerowicz, Aleksandra Bańkowski, Tomasz Protasiewicz, Marcin Pressure gradient measurement to verify hemodynamic results of the chimney endovascular aortic repair (chEVAR) technique |
title | Pressure gradient measurement to verify hemodynamic results of the chimney endovascular aortic repair (chEVAR) technique |
title_full | Pressure gradient measurement to verify hemodynamic results of the chimney endovascular aortic repair (chEVAR) technique |
title_fullStr | Pressure gradient measurement to verify hemodynamic results of the chimney endovascular aortic repair (chEVAR) technique |
title_full_unstemmed | Pressure gradient measurement to verify hemodynamic results of the chimney endovascular aortic repair (chEVAR) technique |
title_short | Pressure gradient measurement to verify hemodynamic results of the chimney endovascular aortic repair (chEVAR) technique |
title_sort | pressure gradient measurement to verify hemodynamic results of the chimney endovascular aortic repair (chevar) technique |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046246/ https://www.ncbi.nlm.nih.gov/pubmed/33852618 http://dx.doi.org/10.1371/journal.pone.0249549 |
work_keys_str_mv | AT milnerowiczarturigor pressuregradientmeasurementtoverifyhemodynamicresultsofthechimneyendovascularaorticrepairchevartechnique AT milnerowiczaleksandra pressuregradientmeasurementtoverifyhemodynamicresultsofthechimneyendovascularaorticrepairchevartechnique AT bankowskitomasz pressuregradientmeasurementtoverifyhemodynamicresultsofthechimneyendovascularaorticrepairchevartechnique AT protasiewiczmarcin pressuregradientmeasurementtoverifyhemodynamicresultsofthechimneyendovascularaorticrepairchevartechnique |