Intra-aneurysm sac pressure measurements after endovascular aneurysm repair: differences between shrinking, unchanged, and expanding aneurysms with and without endoleaks

Dias, Nuno; Ivancev, Krassi; Malina, Martin; Resch, Timothy; Lindblad, Bengt; Sonesson, Björn

doi:10.1016/j.jvs.2004.02.041

Cited by 100 publications

(116 citation statements)

References 36 publications

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“…Moreover, van Keulen et al showed that these uneven postoperative alterations of the sac wall can be reflected by sac volume changes which are not directly related to diameter changes, and vice versa. 36 While the postoperative increase in diameter has been associated with high intra-aneurysm pressure, 18 the clinical significance of the expanded sac volume has not been clearly defined yet. However, such a finding can be related to the wall remodeling, consequently redistributing the mechanical stresses exerted on it.…”

Section: Remodeling Of the Aneurysm Wallmentioning

confidence: 99%

“…The PWS levels and distribution depend on the AAA geometry, shape and sac wall thickness, all of which can be modified in the remodeling process after EVAR. 18,20 Furthermore, the presence of an endoleak can influence the applied pressure exerted on the inner surface of the sac, thus modifying the wall stress levels and, consequently, the activity of MMPs. Additionally, areas of high wall stress in the aneurysm wall have been related to inflammation and increased metabolic activity, assessed with 18 F-fluoro-2-deoxyglucose (18-FDG) using positron emission tomography-computed tomography (PET-CT).…”

Section: Association Of Biomarkers With Hemodynamic Changesmentioning

confidence: 99%

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Aneurysm sac shrinkage after endovascular treatment of the aorta: Beyond sac pressure and endoleaks

et al. 2012

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The isolation of the aneurysm sac from systemic pressure and its consequent shrinkage are considered criteria of success after endovascular repair (EVAR). However, the process of shrinkage does not solely depend on the intrasac pressure, the predictive role of which remains ambiguous. This brief review summarizes the additional pathophysiological mechanisms that regulate the biomechanical properties of the aneurysm wall and may interfere with the process of aneurysm sac shrinkage.

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Section: Remodeling Of the Aneurysm Wallmentioning

confidence: 99%

Section: Association Of Biomarkers With Hemodynamic Changesmentioning

confidence: 99%

Aneurysm sac shrinkage after endovascular treatment of the aorta: Beyond sac pressure and endoleaks

et al. 2012

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“…Determining whether the aneurysm sac has been successfully excluded from systemic pressure has been the ultimate goal of EVAR, as well as any postoperative surveillance. The association of sac pressure with its growth following EVAR was studied by Dias, et al 24 ( Figure 3). The mean pressure index, defined as a percentage of mean intraaneurysm pressure relative to the simultaneous mean intra-aortic pressure, was 19% in shrinking aneurysms, 30% in unchanged aneurysms, and 59% in expanding aneurysms with or without endoleaks.…”

Section: Diagnosismentioning

confidence: 99%

Endotension following endovascular aneurysm repair

et al. 2008

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Endovascular aneurysm repair (EVAR) is a new and minimally invasive alternative to open repair for patients with abdominal aortic aneurysm (AAA). Soon after its introduction in 1990, it was recognized that EVAR had potential and distinct advantages in the elective and emergency settings. However, long-term follow-up has shown enlargement of the AAA in a substantial percentage of patients who underwent EVAR with the original-permeability Excluder. Of interest is that sac expansion frequently occurs in the absence of endoleak, often referred to as endotension. The pathophysiology of endoleak is beginning to be elucidated and its management is ready to be established, while controversy still exists about the etiology and clinical consequences of endotension. Fortunately, the incidence of endotension is decreasing and it appears that AAA expansion after EVAR with the original Excluder can be arrested by endovascular relining with a low-permeability Excluder endoprosthesis. The aim of this brief review is to provide historical perspective and a good understanding of the etiology, diagnosis, and management of endotension.

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“…Treatment is successful when there is full suppression of blood flow and systemic pressure in the aneurysmal sac, which prevent rupture [2][3][4] . Although we have achieved significant technological advances since the first generation of aortic stents, recent information from late postoperative follow-up have shown a significant percentage of complications requiring surgical reintervention.…”

Section: Introductionmentioning

confidence: 99%

Alterations of blood flow pattern after triple stent endovascular treatment of saccular abdominal aortic aneurysm: a porcine model.

Oliveira

Aquino

Barros

et al. 2016

Rev. Col. Bras. Cir.

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Objective: to determine the blood flow pattern changes after endovascular treatment of saccular abdominal aortic aneurysm with triple stent. Methods: we conducted a hemodynamic study of seven Landrace and Large White pigs with saccular aneurysms of the infrarenal abdominal aorta artificially produced according to the technique described. The animals were subjected to triple stenting for endovascular aneurysm. We evaluated the pattern of blood flow by duplex scan before and after stent implantation. We used the non-paired Mann-Whitney test for statistical analysis. Results: there was a significant decrease in the average systolic velocity, from 127.4cm/s in the pre-stent period to 69.81cm/s in the post-stent phase. There was also change in the flow pattern from turbulent in the aneurysmal sac to laminate intra-stent. Conclusion: there were changes in the blood flow pattern of saccular abdominal aortic aneurysm after endovascular treatment with triple stent.

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Intra-aneurysm sac pressure measurements after endovascular aneurysm repair: differences between shrinking, unchanged, and expanding aneurysms with and without endoleaks

Cited by 100 publications

References 36 publications

Aneurysm sac shrinkage after endovascular treatment of the aorta: Beyond sac pressure and endoleaks

Aneurysm sac shrinkage after endovascular treatment of the aorta: Beyond sac pressure and endoleaks

Endotension following endovascular aneurysm repair

Alterations of blood flow pattern after triple stent endovascular treatment of saccular abdominal aortic aneurysm: a porcine model.

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