Complex fenestrated and branched endovascular aortic repair significantly increased arterial stiffness, with carotid-femoral pulse wave velocity rising from 10.85 to 15.30 m/s at 1 month (P<0.001).
Cohort (n=41)
Does complex fenestrated and branched endovascular aortic repair alter arterial stiffness and cardiac function in patients with pararenal or thoracoabdominal aortic aneurysms?
Complex endovascular repair of pararenal and thoracoabdominal aortic aneurysms is associated with significant postoperative increases in arterial stiffness and changes in cardiac function, suggesting a need for long-term cardiovascular monitoring.
Absolute Event Rate: 15.3% vs 10.85%
p-value: p=<0.001
BACKGROUND: Previous studies have demonstrated significant changes in arterial stiffness and secondary cardiac effects following endovascular repair of infrarenal or thoracic aortic aneurysms. However, data remain scarce regarding the impact of more extended complex fenestrated and branched endovascular aortic repair (F/BEVAR) for pararenal and thoracoabdominal aortic aneurysms. This study aimed to investigate alterations in arterial stiffness and cardiac function following F/BEVAR. METHODS: A total of 41 patients undergoing F/BEVAR for pararenal or thoracoabdominal aortic aneurysms were prospectively enrolled. Arterial stiffness was evaluated by measuring the carotid-femoral pulse wave velocity (cfPWV). Cardiac function was assessed by left ventricular global longitudinal strain, left atrial volume index, peak atrial longitudinal strain, left ventricular end-diastolic volume, and N-terminal pro-B-type natriuretic peptide. Measurements were obtained preoperatively and at 1 and 6 months postoperatively. RESULTS: Arterial stiffness increased significantly postoperatively. CfPWV increased from 10.85 ± 2.27 preoperatively to 15.30 ± 3.70 m/s at 1 month (P < 0.001) and remained elevated at 14.54 ± 3.90 m/s (P = 0.22), at 6 months. Ventriculoarterial coupling increased (cfPWV/global longitudinal strain ratio - 0.60 ± 0.23 to - 0.79 ± 0.29 m/s%; P < 0.001). Left atrial volume index increased (30.4 ± 13.7 to 33.1 ± 13.6 ml/m CONCLUSION: Endovascular repair of complex aortic aneurysms with F/BEVAR is associated with a significant increase in arterial stiffness and measurable changes in cardiac function. Further research is necessary to better understand the potential implications of these extensive endovascular procedures for the cardiac function in the long-term. In view of these findings, long-term cardiovascular monitoring should be considered for patients undergoing extensive endovascular aortic repair.
Tsotsios et al. (Wed,) conducted a cohort in Pararenal and thoracoabdominal aortic aneurysms (n=41). Complex fenestrated and branched endovascular aortic repair (F/BEVAR) vs. Preoperative baseline was evaluated on Arterial stiffness measured by carotid-femoral pulse wave velocity (cfPWV) at 1 month (p=<0.001). Complex fenestrated and branched endovascular aortic repair significantly increased arterial stiffness, with carotid-femoral pulse wave velocity rising from 10.85 to 15.30 m/s at 1 month (P<0.001).