Key result
Elective open abdominal aortic aneurysm repair significantly increased mean aortic pulse-wave velocity from 7.84 m/sec preoperatively to 10.08 m/sec at 6 months postoperatively (mean change 2.25 m/sec, p<0.0001).
Why the study?
Does open elective AAA repair increase aortic pulse-wave velocity in patients with abdominal aortic aneurysm?
Observational (n=24)
No
Does open elective AAA repair increase aortic pulse-wave velocity in patients with abdominal aortic aneurysm?
Mean Difference: 2.25 (95% CI 1.4–3.1)
Absolute Event Rate: 10.08% vs 7.84%
p-value: p=<0.0001
Open elective AAA repair significantly increases aortic pulse-wave velocity at 6 months, suggesting a potential restoration of aortic stiffness and decreased rupture risk.
Elective open AAA repair was associated with increased aortic PWV at 6 months; hypothesis-generating and should not yet change practice.
BACKGROUND: The main clinical criterion for abdominal aortic aneurysm (AAA) repair operations is an AAA diameter >/=5.5 cm. When AAAs increase in size, specific changes occur in the mechanical properties of the aortic wall. Pulse-wave velocity (PWV) has been used as an indicator of vascular stiffness. A low PWV may predict AAA rupture risk and is an early predictor of cardiovascular mortality. METHODS: We investigated the prognostic value of PWV before and after elective AAA repair procedures. Twenty four patients scheduled for an open AAA repair underwent a preoperative carotid-femoral aortic PWV measurement. A second aortic PWV measurement was carried out 6 months postoperatively. RESULTS: The mean aortic PWV increased from 7.84 +/- 1.85 preoperatively to 10.08 +/- 1.57 m/sec 6 months postoperatively (mean change: 2.25; 95% confidence interval 1.4 to 3.1 m/sec; p<0.0001). The preprocedural PWV measurement did not correlate with AAA diameter (Spearman's rank correlation coefficient rho=0.12; p=0.59). CONCLUSIONS: Whether the increase in aortic PWV postoperatively suggests a decreased cardiovascular risk following AAA repair remains to be established. Aortic PWV should also be investigated as an adjunct tool for assessing AAA rupture risk.
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Paraskevas et al. (2009) conducted an observational in Abdominal aortic aneurysm (n=24). Elective open infrarenal AAA repair vs. Preoperative baseline was evaluated on Aortic pulse-wave velocity (PWV) (mean change: 2.25 m/sec, 95% CI 1.4 to 3.1, p=<0.0001). Elective open abdominal aortic aneurysm repair significantly increased mean aortic pulse-wave velocity from 7.84 m/sec preoperatively to 10.08 m/sec at 6 months postoperatively (mean change 2.25 m/sec, p<0.0001).
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