Department of Cardiovascular Surgery, Harakani State Hospital, Kars, Turkey.
Department of Cardiovascular Surgery, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey. Email:
Cardiovasc J Afr. 2021;32(4):182-187. doi: 10.5830/CVJA-2021-005. Epub 2021 Mar 16.
Volumetric changes in the aneurysm sac were evaluated following endovascular aortic repair (EVAR) in intact abdominal aortic aneurysm (AAA) patients who underwent EVAR.
Fifty-two patients, who underwent EVAR from 2015 to 2019, were analysed retrospectively. A total of 158 computed tomography angiography scans was examined by performing reconsctructive volumetric calculations. Total aneurysm volume (TAV), patent lumen volume (PLV) and thrombuscoated aneurysm wall volume (TCAWV) were calculated. The results obtained at six, 12 and 24 months postoperatively were compared with those of the pre-operative period.
Mean TAV had regressed 7% by the sixth month ( = 0.1), 27% by the 12th month ( = 0.0003) and 19% by the 24th month ( = 0.0008). Mean TCAWV had increased 2% by the sixth month ( = 0.3), and regressed 26% by the 12th month ( = 0.3) and 14% by the 24th month ( = 0.8). Mean PLV had regressed by 20% by the sixth month ( = 0.008), 29% by the 12th month ( = 0.0002) and 26% by the 24th month ( = 0.0006). For each individual proximal, middle and distal measurement, regression was observed at six and 12 months; however, an increase was observed at 24 months compared to the previous follow ups.
The expansion measurements of TAV in the 24th month support the doubts on the medium- to long-term results of EVAR. The largest regression in the aneurysm sac was observed in the distal portion, then in the proximal portion, and the least regression was observed in the middle section.
评估未破裂腹主动脉瘤(AAA)患者行血管内修复(EVAR)后瘤腔体积的变化。
回顾性分析 2015 年至 2019 年接受 EVAR 的 52 例患者。共对 158 例 CT 血管造影扫描进行了重建体积计算。计算总瘤腔体积(TAV)、有效管腔容积(PLV)和血栓覆盖瘤壁体积(TCAWV)。将术后 6、12 和 24 个月的结果与术前结果进行比较。
术后 6 个月 TAV 平均缩小 7%( = 0.1),12 个月缩小 27%( = 0.0003),24 个月缩小 19%( = 0.0008)。TCAWV 在术后 6 个月增加 2%( = 0.3),12 个月缩小 26%( = 0.3),24 个月缩小 14%( = 0.8)。PLV 在术后 6 个月缩小 20%( = 0.008),12 个月缩小 29%( = 0.0002),24 个月缩小 26%( = 0.0006)。在 6 个月和 12 个月时,每个近端、中段和远端测量值均观察到缩小,但与之前的随访相比,24 个月时观察到增加。
24 个月时 TAV 的扩张测量结果对 EVAR 的中远期结果提出了质疑。瘤腔的最大回缩发生在远端,然后是近端,最小的回缩发生在中段。