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1/2019
vol. 84 Cardiovascular radiology
abstract:
Original paper
Aortic sac enlargement after endovascular aneurysm repair: volume-related changes and the impact of intraluminal thrombus
Arminas Skrebunas
1, 2
,
Givi Lengvenis
2
,
Inga Urte Builyte
1
,
Ruta Zulpaite
1
,
Rytis Bliudzius
3
,
Tomas Baltrunas
1, 2
,
Nerijus Misonis
1, 2
,
Germanas Marinskis
1, 2
1.
Clinic of Cardiovascular Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
2.
Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
3.
Centre of Radiology and Nuclear Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
© Pol J Radiol 2019; 84: e530-e536
Online publish date: 2019/12/11
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Purpose
Abdominal aortic aneurysm (AAA) growth after endovascular aneurysm repair (EVAR) is still unpredictable. The issue of optimal frequency of computed tomography angiography for surveillance and its measurement method accuracy remain unclear. We aimed to assess the value of abdominal aneurysm sac volume measurement for detecting expansions and the association of preprocedural intraluminal thrombus (ILT) volume with aneurysm sac growth following EVAR. Material and methods A total of 107 patients underwent elective EVAR. Inclusion criteria provided a cohort of 39 patients. Changes of postoperative maximum aneurysm sac diameter and AAA volume were calculated. Volumetric AAA changes and demographic data of the cases with clinically irrelevant AAA diameter enlargement were evaluated. Preoperative ILT volumes were collected. ILT and AAA sac volume ratio was calculated. Statistical data analysis was performed using standard methods. Results The mean changes of maximum AAA diameter and volume in percentage after EVAR were –5.08 ± 8.20 mm and –13.39 ± 23.32%, respectively. A moderate positive linear correlation between those changes was found (R2 = 0.731; p < 0.0001). The mean relative AAA volume increase in cases without clinically relevant diameter enlargement was 11.50 ± 8.27%. The means of ILT and AAA sac ratios were 0.59 ± 0.17 and 0.52 ± 1.8 in growing AAA sac and in stable or shrinking AAA sac groups, respectively (p = 0.308). Conclusions Volumetric AAA measurement may be useful as an additional method to diameter measurement after EVAR to identify clinically relevant sac growth. Preoperative volume of ILT may not significantly affect the growth rate of AAA after EVAR. keywords:
abdominal aortic aneurysm, intraluminal thrombus, EVAR, follow-up, AAA diameter, AAA volume |