Endovascular Aneurysm Repair Increases Aortic Arterial Stiffness When Compared to Open Repair of Abdominal Aortic Aneurysms
Endovascular Aneurysm Repair Increases Aortic Arterial Stiffness When Compared to Open Repair of Abdominal Aortic Aneurysms
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DOI：
10.1177/1538574416647503
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发表时间：
2016-07-01
影响因子：
0.9
通讯作者：
McDonnell, Ciaran O.
中科院分区：
文献类型：
--
作者：
Gray, Cleona;Goodman, Patrick;McDonnell, Ciaran O.
目的：血管内动脉瘤修复 (EVAR) 相对于开放修复的最初生存优势不会长期持续。脉搏波速度 (PWV) 是动脉僵硬度的衡量标准，PWV 增加是心血管发病率和死亡率增加的独立危险因素。这项前瞻性对比试验研究了主动脉移植物植入对接受开放式或血管内主动脉瘤修复术的患者 PWV 的影响。患者和方法：招募了 34 名患者（15 名开放患者和 19 名 EVAR）。两组患者的人口统计数据相似。使用飞利浦 IU22 血管超声机上的标准化技术计算所有患者术前和术后的脉搏波速度，并对结果进行比较。结果：显示 EVAR 后平均 PWV 有所增加。开放组中检测到的平均术后 PWV 为 9.7 (4.5) 厘米/秒，显着低于 EVAR 组中检测到的升高的 12.2 (+/- 4.5) 厘米/秒。开放修复术后 PWV 平均下降 0.2 (+/- 4.9) 厘米/秒，而 EVAR 组平均增加 3.3 (+/- 3.7) 厘米/秒。结论：EVAR 患者的术后 PWV 测量值明显高于接受开放腹主动脉瘤修复术的患者。从长远来看，接受 EVAR 的患者发生心血管疾病的风险可能更高。需要进行更大规模的研究和更长时间的前瞻性随访。
Objectives: The initial survival advantage seen with endovascular aneurysm repair (EVAR) over open repair does not persist in the long term. Pulse wave velocity (PWV) is a measure of arterial stiffness, and increased PWV is an independent risk factor for increased cardiovascular morbidity and mortality. This prospective comparative pilot study examined the effect of implantation of an aortic graft on PWV in patients undergoing open or endovascular aortic aneurysm repair.Patients and Methods: Thirty-four patients (15 open and 19 EVAR) were recruited. Patient demographics were similar in both the groups. Pulse wave velocity was calculated for all patients preoperatively and postoperatively using a standardized technique on a Philips IU22 Vascular Ultrasound machine and the results compared.Results: An increase in mean PWV following EVAR was demonstrated. The mean postprocedure PWV of 9.7 ( 4.5) cm/sec detected in the open group was significantly lower than the elevated 12.2 (+/- 4.5) cm/sec detected in the EVAR group. The surgical group also demonstrated a mean decrease of 0.2 (+/- 4.9) cm/sec in PWV following open repair compared to a mean increase of 3.3 (+/- 3.7) cm/sec in the EVAR group.Conclusion: EVAR patients have a significantly higher postoperative PWV measurement than those undergoing open abdominal aortic aneurysm repair. Patients who have undergone EVAR may be at a higher risk of cardiovascular morbidity in the long term. A larger scale study with a longer prospective follow-up is required.