Division of Vascular and Transplant Surgery, Department of Surgery, The Catholic University of Korea, South Korea.
Department of Biostatistics, Korea University College of Medicine, South Korea.
Asian J Surg. 2019 Jul;42(7):746-754. doi: 10.1016/j.asjsur.2018.12.006. Epub 2019 Jan 23.
Compared to the diameter measurement, volume measurement of the aneurysm can be an alternative option for accurate evaluation. This study was undertaken to analyze the relationship between the diameter and the volume measurement of the aorta after EVAR.
From January 2012 to December 2016, 82 patients underwent EVAR in our institution. The infrarenal aorta after EVAR was evaluated with regard to maximal aortic diameter (DMAX) and aortic volume. The relationship between the DMAX and the aortic volume measurement after EVAR were analyzed.
The rate of enlargement of aortic volume with endoleak over time was 0.02 cm/month. The rate of enlargement of DMAX with endoleak over time was 0.007 mm/month. The mean rate of enlargement of aortic volume was significantly different from the mean enlargement rate of DMAX (p = 0.02). A ≥12% of increase rate of aortic volume was equivalent to an increase of ≥5 mm in the DMAX after EVAR. Significantly more endoleak occurred in the DMAX-enlargement group than no-enlargement group (100% vs. 26.76%, p < 0.001). Significantly more patients need secondary intervention and treatment of endoleak in the DMAX-enlargement group (p = 0.02 and p < 0.001, respectively). Significantly more endoleak occurred in the aortic volume-enlargement group than no-enlargement group (90.91% vs. 16.67%, p < 0.001). Significantly more patients needed secondary intervention and treatment for endoleak in the aortic volume-enlargement group (p = 0.02 and p < 0.001, respectively).
Volumetric analysis can predict successful EVAR more accurate than diameter measurement. A ≥12% increase in aortic volume was equivalent to a ≥5 mm increase in aortic diameter.
与直径测量相比，动脉瘤的体积测量可以作为准确评估的替代选择。本研究旨在分析 EVAR 后主动脉直径和体积测量之间的关系。
2012 年 1 月至 2016 年 12 月，我院 82 例行 EVAR 治疗。对 EVAR 后肾下主动脉进行最大主动脉直径（DMAX）和主动脉体积评估。分析 EVAR 后 DMAX 与主动脉体积测量之间的关系。
随着时间的推移，漏诊导致主动脉体积增大的速度为 0.02cm/月。随着时间的推移，漏诊导致 DMAX 增大的速度为 0.007mm/月。主动脉体积增大的平均速度明显不同于 DMAX 的平均增大速度（p=0.02）。主动脉体积增大率≥12%相当于 EVAR 后 DMAX 增加≥5mm。漏诊组 DMAX 增大组的漏诊发生率明显高于无增大组（100%比 26.76%，p<0.001）。漏诊组 DMAX 增大患者需要二次介入和漏诊治疗的比例明显高于无增大组（p=0.02 和 p<0.001）。主动脉体积增大组漏诊的发生率明显高于无增大组（90.91%比 16.67%，p<0.001）。主动脉体积增大组需要二次介入和漏诊治疗的患者比例明显高于无增大组（p=0.02 和 p<0.001）。
与直径测量相比，容积分析可以更准确地预测 EVAR 的成功。主动脉体积增加≥12%相当于主动脉直径增加≥5mm。
