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International Angiology 2021 Jul 08

DOI: 10.23736/S0392-9590.21.04691-5


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 the 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) and demonstrated that arterial stiffness is a predictor for determining sac behavior after EVAR.
METHODS AND RESULTS: 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. Univariate and multivariable analyses revealed 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 an independent risk factor for sac shrinkage at 2 year postoperatively. The receiver-operating characteristic curve analysis showed that the optimal cutoff 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: Abdominal aortic aneurysm; Endovascular procedure; Pulse wave analysis

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