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Title: Systemic Pulsatile Pressure in Type II Endoleaks After Stent Grafting of Experimental Abdominal Aortic Aneurysms

Purpose: To investigate pressure and maximum rate of rise of systolic pressure (peak dP/dt) in completely excluded aneurysms and endoleaks to determine the hemodynamic impact of endoleaks. Methods: In mongrel dogs (n =36) experimental aneurysms were created by insertion of a patch (portion of rectus abdomen is muscle sheath) into the infrarenalaorta. In group I (n 18), all aortic branches of the aneurysm were ligated and all aneurysms were completely excluded by stent grafts. Group II (n = 18) consisted of aneurysms with patent aortic side branches that represented sources of endoleaks.One week (n = 12), six weeks (n = 12),and six months (n = 12) after stent grafting,hemodynamic measurements were obtained in thrombosed aneurysms and proved endoleaks. Systemic blood pressure and intraaneurysmal pressure were simultaneously measured and the respective peak dP/dt were computed. Results: At the six-month follow-up, the systolic-pressure ratio (intraaneurysmatic pressure: systemic pressure)was significantly increased in endoleaks compared to non-perfused areas(0.879 {+-} 0.042 versus 0.438 {+-} 0.176, p <0.01, group II) or completely excluded aneurysms (0.385 {+-}0.221, group I). Peak dP/dt ratio (intraaneurysmal peak dP/dt: systemic peak dP/dt) was 0.922 {+-} 0.154 in endoleaks, compared to 0.084 {+-} 0.080 in non-perfused areas (group II, p <0.01), andmore » was 0.146 {+-} 0.121 in completely excluded aneurysms (group I). The diastolic-pressure ratio was also increased inendoleaks compared to non-perfused areas (0.929 {+-} 0.088 versus 0.655 {+-} 0.231, p < 0.01, group II) or completely excluded aneurysms (0.641 {+-} 0.278, group I). In excluded aneurysms, pressure exposure declined as the length of the follow-up period increased. Conclusion: Type II endoleaks transmit pulsatile pressure of near systemic level and indicate insufficient treatment result. In contrast, complete endovascular exclusion of aneurysms results in significantly reduced pressure exposure.« less
Authors:
;  [1] ;  [2] ;  [3] ;  [1]
  1. University Hospital, Johannes Gutenberg University of Mainz, Langenbeckstrasse 1, 55101 Mainz, Department of Radiology (Germany)
  2. UniversityHospital of Mannheim, Mannheim, Department of Radiology (Germany)
  3. University Hospital, Johannes Gutenberg University ofMainz, Mainz, Department of Cardiothoracic and VascularSurgery (Germany)
Publication Date:
OSTI Identifier:
21088389
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 26; Journal Issue: 3; Other Information: DOI: 10.1007/s00270-003-2689-7; Copyright (c) 2003 Springer-Verlag New York, Inc.; www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BLOOD PRESSURE; DOGS; GRAFTS; MUSCLES; PATENTS; VASCULAR DISEASES