Remodeling of proximal neck angulation after endovascular aneurysm repair

Ishibashi, Hiroyuki; Ishiguchi, Tsuneo; Ohta, Takashi; Sugimoto, Ikuo; Yamada, Tetsuya; Tadakoshi, Masao; Hida, Noriyuki; Orimoto, Yuki

doi:10.1016/j.jvs.2012.04.014

Cited by 20 publications

(11 citation statements)

References 17 publications

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“…Postimplant imaging studies were used in these cases, potentially underestimating preoperative baseline neck angulation or neck thrombus content and overestimating baseline neck diameter in the endoleak subgroup, to the extent and direction that these measures are known to change after endograft implantation. [24][25][26] This limitation may underlie the failure to identify certain variables as risk factors for type Ia endoleak.…”

Section: Discussionmentioning

confidence: 99%

Outcome-based anatomic criteria for defining the hostile aortic neck

Jordan¹,

Ouriel²,

Mehta³

et al. 2015

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Outcome-based anatomic criteria for defining the hostile aortic neck

Jordan¹,

Ouriel²,

Mehta³

et al. 2015

Journal of Vascular Surgery

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“…Many researchers reported the disadvantages and poor outcomes of EVAR in the treatment of aneurysms with hostile neck anatomy that did not meet the criteria [ 16 - 18 ]. The neck angle decreased significantly within 1 week after EVAR and then gradually decreased thereafter [ 6 , 7 , 19 ]. When the preoperative neck angle was greater than 60°, it decreased immediately after EVAR [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…The neck angle decreased significantly within 1 week after EVAR and then gradually decreased thereafter [ 6 , 7 , 19 ]. When the preoperative neck angle was greater than 60°, it decreased immediately after EVAR [ 19 ]. In our study, there was a significant decrease in the neck angle immediately after EVAR, similar to those in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Changes in Neck Angle, Neck Length, Maximum Diameter, Maximum Area and Thrombus after Endovascular Aneurysm Repair

Lee

Park

Kwak

2020

VSI

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Purpose The correlation of initial anatomy of the aneurysm, aneurysmal remodeling and endoleaks is controversial. We performed a retrospective study to measure aneurysmal remodeling with time, and to assess the structural changes in the aneurysm neck after endovascular aneurysm repair (EVAR). Materials and Methods From January 2013 to February 2018, 108 patients with abdominal aortic aneurysms (AAA) underwent EVAR. Follow-up computed tomography images were available for 90 patients. Anatomic variables, including the neck angle, neck length, maximal diameter, maximal area, and thrombus volume were measured. Temporal changes were measured preoperatively, immediate postoperatively (within 1 week after EVAR), and at 6 months, 1 year, and 2 years post-EVAR. Correlation between the variables according to the temporal changes and presence of type Ia endoleaks (T1aE) was analyzed. Results The mean follow-up period was 10.63±20.34 months. Significant decreases in neck angle and length occurred immediately postoperative (P<0.001 and 0.036). Maximum diameter decreased at 6 months post-EVAR (P=0.003), but no significant changes in the maximal area occurred over time (P=0.142). Thrombus volume in the aneurysm sac increased immediately post-EVAR (P=0.008). There was no significant relationship between T1aE and neck changes in the group and time comparison (P=0.815 and 0.970). Conclusion Changes in neck angle, length and thrombus volume occurred immediately after EVAR, whereas a change in the maximum diameter of the AAA was noted 6 months after EVAR. Preoperative anatomic variables related with T1aE were not found.

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“…9 Despite guidewire removal after stent-graft placement, a straightening effect of EVAR on the aorta has been reported. 31,32 However, lengths are underestimated implicitly, not as a quantitative simulation. Degrees of underestimation vary between software applications, which impairs comparability and safety unless communicated to the user.…”

Section: Discussionmentioning

confidence: 99%