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Intraoperative Sac Pressure Measurement During Endovascular Abdominal Aortic Aneurysm Repair

Intraoperative Sac Pressure Measurement During Endovascular Abdominal Aortic Aneurysm Repair,10.1007/s00270-010-9813-2,Cardiovascular and Intervention

Intraoperative Sac Pressure Measurement During Endovascular Abdominal Aortic Aneurysm Repair  
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Purpose  Intraoperative sac pressure was measured during endovascular abdominal aortic aneurysm repair (EVAR) to evaluate the clinical significance of sac pressure measurement. Methods  A microcatheter was placed in an aneurysm sac from the contralateral femoral artery, and sac pressure was measured during EVAR procedures in 47 patients. Aortic blood pressure was measured as a control by a catheter from the left brachial artery. Results  The systolic sac pressure index (SPI) was 0.87 ± 0.10 after main-body deployment, 0.63 ± 0.12 after leg deployment (P P P P < 0.01), respectively. SPI showed no significant differences between the Zenith and Excluder stent grafts (0.56 ± 0.13 vs. 0.54 ± 0.10, NS). Type I endoleak was found in seven patients (15%), and the SPI decreased from 0.62 ± 0.10 to 0.55 ± 0.10 (P = 0.10) after fixing procedures. Type II endoleak was found in 12 patients (26%) by completion angiography. The SPI showed no difference between type II endoleak positive and negative (0.58 ± 0.12 vs. 0.55 ± 0.12, NS). There were no significant differences between the final SPI of abdominal aortic aneurysms in which the diameter decreased in the follow-up and that of abdominal aortic aneurysms in which the diameter did not change (0.53 ± 0.12 vs. 0.57 ± 0.12, NS). Conclusions  Sac pressure measurement was useful for instant hemodynamic evaluation of the EVAR procedure, especially in type I endoleaks. However, on the basis of this small study, the SPI cannot be used to reliably predict sac growth or regression.
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