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Supra- and Infra-Renal Aortic Neck Diameter Increase after Endovascular Repair of a Ruptured Abdominal Aortic Aneurysm

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 possi...

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Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910909/
https://www.ncbi.nlm.nih.gov/pubmed/35268292
http://dx.doi.org/10.3390/jcm11051203
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author 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.
author_facet 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.
author_sort van der Riet, Claire
collection PubMed
description 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.
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spelling pubmed-89109092022-03-11 Supra- and Infra-Renal Aortic Neck Diameter Increase after Endovascular Repair of a Ruptured Abdominal Aortic Aneurysm 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. J Clin Med Article 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. MDPI 2022-02-23 /pmc/articles/PMC8910909/ /pubmed/35268292 http://dx.doi.org/10.3390/jcm11051203 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
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.
Supra- and Infra-Renal Aortic Neck Diameter Increase after Endovascular Repair of a Ruptured Abdominal Aortic Aneurysm
title Supra- and Infra-Renal Aortic Neck Diameter Increase after Endovascular Repair of a Ruptured Abdominal Aortic Aneurysm
title_full Supra- and Infra-Renal Aortic Neck Diameter Increase after Endovascular Repair of a Ruptured Abdominal Aortic Aneurysm
title_fullStr Supra- and Infra-Renal Aortic Neck Diameter Increase after Endovascular Repair of a Ruptured Abdominal Aortic Aneurysm
title_full_unstemmed Supra- and Infra-Renal Aortic Neck Diameter Increase after Endovascular Repair of a Ruptured Abdominal Aortic Aneurysm
title_short Supra- and Infra-Renal Aortic Neck Diameter Increase after Endovascular Repair of a Ruptured Abdominal Aortic Aneurysm
title_sort supra- and infra-renal aortic neck diameter increase after endovascular repair of a ruptured abdominal aortic aneurysm
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910909/
https://www.ncbi.nlm.nih.gov/pubmed/35268292
http://dx.doi.org/10.3390/jcm11051203
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