Key result
Intra-aneurysm sac pressure measurement using a thin pressure wire during EVAR was feasible and safe, showing a significant reduction in systolic aneurysm sac pressure to 65.6 mm Hg compared to an aortic pressure of 107.4 mm Hg after balloon post-dilatation.
Why the study?
Endoleaks after EVAR are common but cannot always be visualized during the procedure, making novel endoleak assessment methods like aneurysm sac pressure measurement urgently needed.
Is intra-aneurysm sac pressure measurement using a thin pressure wire safe and feasible during EVAR?
Observational (n=23)
No
Is intra-aneurysm sac pressure measurement using a thin pressure wire safe and feasible during EVAR?
Absolute Event Rate: 65.6% vs 107.4%
p-value: p=<0.001
Intra-aneurysm sac pressure measurement using a thin pressure wire during EVAR is feasible, safe, and demonstrates significant pressure drops in the sac following stent graft deployment and ballooning.
Supports feasibility of thin-wire sac pressure monitoring in EVAR; leaves open impact on clinical outcomes.
BACKGROUND: An endoleak is a typical complication of endovascular aneurysm repair (EVAR). It is characterized by persistent blood flow between a stent graft and the aneurysm sac. Usually, it can be visualized during primary EVAR, but in many cases, this remains impossible. Therefore, other methods of endoleak assessment are urgently needed. The measurement of aneurysm sac pressure (ASP) seems to be a promising direction of research in this area. OBJECTIVES: We aimed to evaluate the safety and efficacy of a new method for invasive pressure measurement inside the abdominal aortic aneurysm (AAA) during EVAR. We also assessed a correlation between pressure values and early angiographic occurrence of an endoleak after the procedure. MATERIAL AND METHODS: A total of 20 patients with AAA were included in this experimental prospective study. During EVAR, systolic, diastolic and mean pressure values were recorded both for ASP and aortic pressure (AP) before procedure, after stent graft opening and after final stent graft ballooning. RESULTS: The measurements were successfully obtained in all participants without any complications. There were no significant differences between all ASP and AP before procedure. After the procedure, blood pressure significantly decreased in the aneurysm sac but not in the aorta. Systolic ASP was significantly lower than systolic AP both after stent graft opening (80.4 ±20.9 mm Hg compared to 110.7 ±21.6 mm Hg, p < 0.01) and after its balloon post-dilatation (65.6 ±26.1 mm Hg compared to 107.4 ±22.1 mm Hg, p < 0.001). Diastolic ASP decreased significantly in comparison to diastolic AP only after stent graft ballooning (48.0 ±14.6 mm Hg compared to 56.4 ±13.6 mm Hg, p < 0.05). CONCLUSIONS: Our study confirmed that the novel method for the measurement of ASP during EVAR, using a thin pressure wire, is feasible and safe.
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Antkiewicz et al. (2021) conducted an observational in Abdominal aortic aneurysm (n=23). Intra-aneurysm sac pressure measurement using a thin pressure wire vs. Aortic pressure measurement was evaluated on Systolic pressure after stent graft balloon post-dilatation (p=<0.001). Intra-aneurysm sac pressure measurement using a thin pressure wire during EVAR was feasible and safe, showing a significant reduction in systolic aneurysm sac pressure to 65.6 mm Hg compared to an aortic pressure of 107.4 mm Hg after balloon post-dilatation.
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