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Titolo:
Aneurysm sac pressure measurements after endovascular repair of abdominal aortic aneurysms
Autore:
Baum, RA; Carpenter, RP; Cope, C; Golden, MA; Velazquez, OC; Neschis, DG; Mitchell, ME; Barker, CF; Fairman, RM;
Indirizzi:
Univ Penn, Med Ctr, Dept Radiol, Sect Intervent Radiol, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 nt Radiol, Philadelphia, PA 19104 USA Univ Penn, Med Ctr, Dept Surg, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 Dept Surg, Philadelphia, PA 19104 USA
Titolo Testata:
JOURNAL OF VASCULAR SURGERY
fascicolo: 1, volume: 33, anno: 2001,
pagine: 32 - 40
SICI:
0741-5214(200101)33:1<32:ASPMAE>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
ENDOLUMINAL REPAIR; RUPTURE; EMBOLIZATION; ENDOLEAK; ARTERY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Baum, RA Univ Penn, Med Ctr, Dept Radiol, Sect Intervent Radiol, 3400 Spruce St, Philadelphia, PA 19104 USA Univ Penn 3400 Spruce St Philadelphia PA USA 19104 , PA 19104 USA
Citazione:
R.A. Baum et al., "Aneurysm sac pressure measurements after endovascular repair of abdominal aortic aneurysms", J VASC SURG, 33(1), 2001, pp. 32-40

Abstract

Objectives: The goal of endovascular grafting of abdominal aortic aneurysms (AAAs) is to exclude the aneurysm sac from systemic pressure and thereby decrease the risk of rupture. Unlike conventional open surgery, branch vessels in the sac (eg, lumbar artery and inferior mesenteric artery [IMA]) arenot ligated and can potentially transmit pressure. The purpose of our investigation was to evaluate the feasibility of various interventional techniques for measuring pressure within the aneurysm sac in patients who had undergone endovascular repair of AAAs. Methods: Sac pressure measurements were performed in 21 patients who had undergone stent graft repair of AAAs. Seventeen of 21 patients had endoleaksdemonstrated on 30-day computed tomographic (CT) scans. Access to the aneurysm sac in these patients was through direct translumbar sac puncture (5 patients), through a patent IMA accessed via the superior mesenteric artery (SMA) (9 patients), or by direct cannulation around attachment sites (3 patients). Pour patients had perioperative pressure measurements obtained through catheters positioned along side of the endovascular graft at the time of its deployment. Two of these catheters were left in position for 30 hoursduring which time CT and conventional angiography were performed. Pressures were determined with standard arterial-line pressure transduction techniques and compared with systemic pressure in each patient. Results: Elevated sac pressure was found in all patients. The sac pressurein patients with endoleaks was found to be systemic (15 patients) or near systemic (2 patients) and all had pulsatile waveforms. Elevated sac pressures were also found in patients without CT or angiographic evidence of endoleak (2 patients). Injection of the sacs in two of these patients revealed apatent lumbar artery and an IMA. Conclusions: It is possible to measure pressures from within the aneurysm sac in patients with stent grafts with a variety of techniques. Patients may continue to have pressurized AAA sacs despite endovascular AAA repair. Endoleaks transmit pulsatile pressure into the aneurysm sac regardless of thetype. It is possible to have systemic sac pressures without evidence of endoleaks on CT or angiography.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/10/20 alle ore 13:03:13