Department of Vascular and Endovascular Surgery, 61059University of Cologne, Cologne, Germany.
Department of Vascular Surgery, Medical School, 68989University of Athens, Athens, Greece.
Vasc Endovascular Surg. 2021 Nov;55(8):804-810. doi: 10.1177/15385744211023281. Epub 2021 Jun 11.
The aim of the present study was to investigate a potential difference on the arterial stiffness among aneurysm patients and non-aneurysm controls, as well as to explore potential changes between patients treated either with endovascular or open repair.
A 110 patients with an infrarenal AAA were prospectively enrolled in this study. Fifty-six patients received an EVAR, whereas 54 patients received an open surgical repair. Moreover, 103 gender and age-matched subjects without AAA served as controls. The cardio-ankle vascular index (CAVI) was applied for measurement of the arterial stiffness.
CAVI values were statistically higher in the AAA patients when compared with control subjects. Although at 48 hours postoperatively the CAVI values were increased in both groups when compared to baseline values, the difference in CAVI had a tendency to be higher in the open group compared to the endovascular group. At 6 months of follow up the CAVI values returned to the baseline for the patients of the open repair group. However, in the endovascular group CAVI values remained higher when compared with the baseline values.
Patients with AAAs demonstrated a higher value of CAVI compared to healthy controls. A significant increase of arterial stiffness in both groups during the immediate postoperative period was documented. The increase in arterial stiffness remained significant at 6 months in EVAR patients. Further studies are needed to elucidate the impact of a decreased aortic compliance after stentgraft implantation on the cardiac function of patients with AAA.
本研究旨在探讨腹主动脉瘤(AAA)患者与非 AAA 对照者之间动脉僵硬度的潜在差异,并探讨血管内修复(EVAR)与开放修复治疗患者之间的潜在变化。
本前瞻性研究纳入了 110 例肾下型 AAA 患者。其中 56 例患者接受 EVAR,54 例患者接受开放手术修复。此外,还纳入了 103 名性别和年龄匹配的无 AAA 对照者。应用脉波传导速度(baPWV)和中心动脉压(cSBP)计算心血管踝臂指数(CAVI),用于测量动脉僵硬度。
AAA 患者的 CAVI 值明显高于对照组。尽管与基线值相比,两组患者术后 48 小时的 CAVI 值均升高,但与 EVAR 组相比,开放组的 CAVI 值升高趋势更为明显。在 6 个月的随访中,开放修复组患者的 CAVI 值恢复到基线水平。然而,EVAR 组的 CAVI 值仍高于基线值。
AAA 患者的 CAVI 值高于健康对照组。本研究记录了两组患者在术后即刻动脉僵硬度显著增加。EVAR 患者的动脉僵硬度增加在 6 个月时仍保持显著。进一步的研究需要阐明支架植入后主动脉顺应性降低对 AAA 患者心功能的影响。