Endovascular aortic aneurysm repair increased carotid-femoral pulse wave velocity from 11.3 m/s at baseline to 12.4 m/s at discharge (p=0.005), remaining elevated through 1 year.
Observational (n=20)
Does elective endovascular aneurysm repair (EVAR) affect arterial stiffness and central hemodynamics in patients with infrarenal abdominal aortic aneurysm?
Elective EVAR for infrarenal abdominal aortic aneurysm is associated with a sustained increase in arterial stiffness (cfPWV) at 1 year, potentially indicating increased cardiovascular risk.
Absolute Event Rate: 12.4% vs 11.3%
p-value: p=0.005
PURPOSE: To evaluate the impact of elective endovascular aneurysm repair (EVAR) on the carotid-femoral pulse wave velocity (cfPWV) and central pressure waveform, through 1-year follow-up. MATERIALS AND METHODS: A tonometric device was used to measure cfPWV and estimate the central pressure waveform in 20 patients with an infrarenal abdominal aortic aneurysm scheduled for elective EVAR. The evaluated central hemodynamic parameters included the central pressures, the augmentation index (AIx), and the subendocardial viability ratio (SEVR). AIx quantifies the contribution of reflected wave to the central systolic pressure, whereas SEVR describes the myocardial perfusion relative to the cardiac workload. Measurements were performed before EVAR, at discharge, and 6 weeks and 1 year after EVAR. RESULTS: CfPWV was increased at discharge (12.4±0.4 vs 11.3±0.5 m/s at baseline; p=0.005) and remained elevated over the course of 1-year follow-up (6 weeks: cfPWV = 12.2±0.5 m/s; 1 year: cfPWV = 12.2±0.7 m/s, p<0.05). After an initial drop in systolic central pressure at discharge, all the central pressures increased thereafter up to 1 year, without significant differences compared with baseline. The same was observed for the AIx and SEVR. CONCLUSION: Endovascular aortic aneurysm repair caused an increase in pulse wave velocity compared with baseline, which remained elevated through 1 year follow-up, which may be related to an increased cardiovascular risk. However, no differences in central pressure, augmentation index, and subendocardial viability ration were observed during follow-up.
Holewijn et al. (Fri,) conducted a observational in Infrarenal abdominal aortic aneurysm (n=20). Endovascular aneurysm repair (EVAR) vs. Baseline (before EVAR) was evaluated on Carotid-femoral pulse wave velocity (cfPWV) at discharge (p=0.005). Endovascular aortic aneurysm repair increased carotid-femoral pulse wave velocity from 11.3 m/s at baseline to 12.4 m/s at discharge (p=0.005), remaining elevated through 1 year.