Details

Autor(en) / Beteiligte

• Jeong, Min-Jae
• Kwon, Hyunwook
• Ko, Gi-Young
• Gwon, Dong Il
• Kim, Min-Ju
• Han, Youngjin
• Kwon, Tae-Won
• Cho, Yong-Pil

Titel

New predictors of aneurysm sac behavior after endovascular aortic aneurysm repair

Ist Teil von

• European radiology, 2019-12, Vol.29 (12), p.6591-6599

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2019

Link zum Volltext

Quelle

SpringerLink (Online service)

Beschreibungen/Notizen

• Objectives This study aimed to identify new predictors of sac behavior after endovascular aortic aneurysm repair (EVAR) and to investigate whether sac behavior is associated with long-term clinical outcomes. Methods A total of 168 patients undergoing successful EVAR for abdominal aortic aneurysms with CTA follow-up of at least 1 year were included. Predictors of aneurysm sac behavior and its impact on long-term clinical outcomes were retrospectively analyzed. Results According to sac behavior, eligible patients were stratified into the sac regression group ( n  = 79, 47.0%) and the sac non-regression group ( n  = 89, 53.0%). Patients in the regression group were younger ( p  = 0.036) and more likely to take sarpogrelate hydrochloride postoperatively ( p  = 0.011) than those in the non-regression group. The incidence of postimplantation syndrome (PIS) was significantly higher in the regression group ( p  = 0.005). On multivariate analysis, sac regression was more likely to occur in those with PIS (hazard ratio [HR], 1.68; 95% confidence interval [CI], 1.07–2.64; p  = 0.023) and less likely to occur in those with transient type II endoleaks (HR, 0.43; 95% CI, 0.20–0.95; p  = 0.037) and higher thrombus density within the sac on follow-up CTA (HR, 0.97; 95% CI, 0.95–0.99; p  = 0.013). Non-regression of the sac was associated with significantly higher rates of re-intervention during the follow-up period ( p  = 0.001). Conclusions In addition to type II endoleaks, PIS and thrombus density are new predictors of aneurysm sac behavior, and sac regression is significantly associated with lower rates of re-intervention. Key Points • After endovascular aortic aneurysm repair (EVAR), patients with sac regression were younger and more likely to take sarpogrelate hydrochloride postoperatively than those with sac non-regression. • The incidence of postimplantation syndrome (PIS) was significantly higher in patients with sac regression. • In our analysis, PIS and thrombus density within the sac were newly identified predictors of aneurysm sac behavior after EVAR.