Aneurysm Wall Enhancement Detected by Contrast Computed Tomography Scan Is Associated With Aneurysm Shrinkage After Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm

• Published in: Circulation Journal 2018/01/25, Vol.82(2), pp.340-345
• Main Authors: Ito, Eisaku, Toya, Naoki, Fukushima, Soichiro, Murakami, Yuri, Akiba, Tadashi, Ohki, Takao
• Format: Article
• Language: English
• Subjects: Abdominal aortic aneurysm; Adult; Aged; Aged, 80 and over; Aneurysm wall enhancement; Aortic Aneurysm, Abdominal - complications; Aortic Aneurysm, Abdominal - diagnostic imaging; Aortic Aneurysm, Abdominal - pathology; Aortic Aneurysm, Abdominal - surgery; Aortic Rupture - etiology; Contrast Media; Endoleak - etiology; Endovascular aneurysm repair; Endovascular Procedures - adverse effects; Endovascular Procedures - methods; Female; Follow-Up Studies; Humans; Male; Middle Aged; Retrospective cohort; Stents; Thrombosis - etiology; Tomography, X-Ray Computed - methods; Treatment Outcome; Type II endoleak
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-17-0786

Background:Aneurysm expansion, and consequent endoleaks, after endovascular aneurysm repair (EVAR) is a major problem. Accurate prediction of aneurysm expansion is demanding for surgeons and remains difficult.Methods and Results:We retrospectively analyzed 157 cases of EVAR for abdominal aortic aneurysm (AAA) using a bifurcated main-body stent-graft. There were 62 cases of aneurysm shrinkage after EVAR, 63 cases of stable aneurysm, and 32 cases of aneurysm expansion. Type I endoleaks were significantly increased in the aneurysm expansion group (EXP) compared with the stable (STB) and shrinkage (SHR) groups (EXP: 15.6% vs. STB: 4.8% vs. SHR: 0%, P=0.005). Type II endoleaks were also significantly increased in EXP (EXP: 65.6% vs. STB: 36.5% vs. SHR: 6.5%, P