ORIGINAL ARTICLE  AORTIC DISEASE Free access

International Angiology 2021 October;40(5):409-15

DOI: 10.23736/S0392-9590.21.04691-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Association of preoperative pulse wave velocity to aneurysm sac shrinkage after endovascular aneurysm repair

Toshiya NISHIBE ¹ ✉, Masaki KANO ¹, Koki MAEKAWA ¹, Shinobu AKIYAMA ¹, Saori NUKAGA ¹, Jun KOIZUMI ², Alan DARDIK ³, Hitoshi OGINO ¹

¹ Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan; ² Department of Radiology, Chiba University School of Medicine, Chiba, Japan; ³ Department of Surgery, Yale University School of Medicine, New Haven, CT, USA

BACKGROUND: Arterial stiffness may be the underlying cause of divergent sac behavior after endovascular aortic repair (EVAR). We evaluated arterial stiffness using pulse wave velocity (PWV) in patients undergoing EVAR for abdominal aortic aneurysm (AAA) to determine whether arterial stiffness predicts sac behavior after EVAR.
METHODS: One hundred nineteen patients with infrarenal AAA undergoing EVAR between November 2013 and July 2019 were included in this study. Preoperative brachial-ankle PWV was measured using an automated oscillometric method at our Vascular Laboratory. PWV and other risk factors were assessed with respect to being a risk factor for sac shrinkage at 2 years postoperatively.
RESULTS: Univariable and multivariable analyses revealed both preoperative PWV (odds ratio [OR]=0.87; 95% confidence interval [CI]: 0.79-0.98; P=0.045) and the incidence of operative type II endoleak (OR 0.68; 95% CI 0.10-0.81; P=0.048) as independent risk factors for sac shrinkage at 2 year postoperatively. The receiver-operating characteristic curve analysis showed that the optimal cut-off value for predicting sac shrinkage was 17.79 m/s, and significantly predicted sac shrinkage.
CONCLUSIONS: Preoperative PWV was independently associated with sac shrinkage after EVAR, suggesting that arterial stiffness may be one of the key factors for determining sac behavior after EVAR.

KEY WORDS: Aortic aneurysm, abdominal; Endovascular procedures; Pulse wave analysis