Key result
Higher preoperative pulse wave velocity was independently associated with a reduced likelihood of aneurysm sac shrinkage at 2 years after endovascular aortic repair (OR 0.87; 95% CI 0.79-0.98; P=0.045).
Why the study?
Arterial stiffness may cause divergent sac behavior after EVAR, but whether arterial stiffness evaluated by pulse wave velocity predicts sac behavior after EVAR was undetermined.
Does preoperative pulse wave velocity predict aneurysm sac shrinkage at 2 years after EVAR in patients with infrarenal AAA?
Cohort (n=119)
No
Does preoperative pulse wave velocity predict aneurysm sac shrinkage at 2 years after EVAR in patients with infrarenal AAA?
Preoperative brachial-ankle pulse wave velocity is independently associated with aneurysm sac shrinkage after EVAR, suggesting arterial stiffness influences sac behavior.
Answers are grounded in this paper and cite their sources.
Higher preoperative PWV was associated with reduced sac shrinkage after EVAR; hypothesis-generating and should not yet change practice.
BACKGROUND: Arterial stiffness may be the underlying cause of divergent sac behavior after endovascular aortic repair (EVAR). We evaluated arterial stiffness using pulse wave velocity (PWV) in patients undergoing EVAR for abdominal aortic aneurysm (AAA) to determine whether arterial stiffness predicts sac behavior after EVAR. METHODS: One hundred nineteen patients with infrarenal AAA undergoing EVAR between November 2013 and July 2019 were included in this study. Preoperative brachial-ankle PWV was measured using an automated oscillometric method at our Vascular Laboratory. PWV and other risk factors were assessed with respect to being a risk factor for sac shrinkage at 2 years postoperatively. RESULTS: Univariable and multivariable analyses revealed both preoperative PWV (odds ratio [OR]=0.87; 95% confidence interval [CI]: 0.79-0.98; P=0.045) and the incidence of operative type II endoleak (OR 0.68; 95% CI 0.10-0.81; P=0.048) as independent risk factors for sac shrinkage at 2 year postoperatively. The receiver-operating characteristic curve analysis showed that the optimal cut-off value for predicting sac shrinkage was 17.79 m/s, and significantly predicted sac shrinkage. CONCLUSIONS: Preoperative PWV was independently associated with sac shrinkage after EVAR, suggesting that arterial stiffness may be one of the key factors for determining sac behavior after EVAR.
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Nishibe et al. (2021) conducted a cohort in Infrarenal abdominal aortic aneurysm (AAA) undergoing EVAR (n=119). Preoperative pulse wave velocity (PWV) was evaluated on Aneurysm sac shrinkage at 2 years postoperatively (OR 0.87, 95% CI 0.79-0.98, p=0.045). Higher preoperative pulse wave velocity was independently associated with a reduced likelihood of aneurysm sac shrinkage at 2 years after endovascular aortic repair (OR 0.87; 95% CI 0.79-0.98; P=0.045).
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