Factors Influencing on the Aneurysm Sac Shrinkage after Endovascular Abdominal Aortic Aneurysm Repair by the Analysis of the Patients with the Aneurysm Sac Shrinkage and Expansion
Objectives: The aneurysmal sac shrinkage has been reported as the strong predictor of favorable long-term outcome after endovascular aneurysm repair (EVAR). We evaluated the effects of perioperative and intraoperative factors on the aneurysm sac shrinkage.Methods: EVAR was performed for 296 patients...
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| Veröffentlicht in: | Annals of Vascular Diseases 2023, Vol.16(4), pp.245-252 |
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| creator | Aoki, Atsushi Maruta, Kazuto Masuda, Tomoaki Omoto, Tadashi |
| description | Objectives: The aneurysmal sac shrinkage has been reported as the strong predictor of favorable long-term outcome after endovascular aneurysm repair (EVAR). We evaluated the effects of perioperative and intraoperative factors on the aneurysm sac shrinkage.Methods: EVAR was performed for 296 patients during August 2009–December 2021. Nine patients with type Ia, Ib, or III; 69 patients with the sac diameter change less than 5 mm; and five patients with sac re-expansion after shrunk more than 5 mm were excluded. Thus, patients with sac shrinkage 5 mm or more (79 patients, shrinkage group) and with sac expansion 5 mm or more (18 patients) were included in this study. Antifibrinolytic therapy with tranexamic acid (TXA) 1500 mg/day for 6 months after EVAR was introduced in March 2013 and patent aortic side branches were coil embolized during EVAR since July 2015. Patients’ background and patent aortic side branches at the end of EVAR were evaluated.Results: Univariate analysis for comparison between patients with sac shrinkage and sac expansion revealed that males (82.3% vs. 55.6%, p = 0.021), without antiplatelet therapy (40.5% vs. 66.7%, p = 0.044) and TXA (79.8% vs. 38.9%, p |
| doi_str_mv | 10.3400/avd.avd.oa.23-00065 |
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We evaluated the effects of perioperative and intraoperative factors on the aneurysm sac shrinkage.Methods: EVAR was performed for 296 patients during August 2009–December 2021. Nine patients with type Ia, Ib, or III; 69 patients with the sac diameter change less than 5 mm; and five patients with sac re-expansion after shrunk more than 5 mm were excluded. Thus, patients with sac shrinkage 5 mm or more (79 patients, shrinkage group) and with sac expansion 5 mm or more (18 patients) were included in this study. Antifibrinolytic therapy with tranexamic acid (TXA) 1500 mg/day for 6 months after EVAR was introduced in March 2013 and patent aortic side branches were coil embolized during EVAR since July 2015. Patients’ background and patent aortic side branches at the end of EVAR were evaluated.Results: Univariate analysis for comparison between patients with sac shrinkage and sac expansion revealed that males (82.3% vs. 55.6%, p = 0.021), without antiplatelet therapy (40.5% vs. 66.7%, p = 0.044) and TXA (79.8% vs. 38.9%, p <0.001), were significantly associated with sac shrinkage. By multivariate analysis, the odds ratio of sac shrinkage was 11.7 for males, 0.1 for the patients on antiplatelet therapy, and 6.5 for the patient who received TXA. The patients with patent inferior mesenteric artery (IMA) were less in the shrinkage group (20.3% vs. 77.8%, p <0.001) and with two or less patent lumbar arteries (LAs) were more in the shrinkage group (82.3% vs. 33.3%, p < 0.001). The odd ratio of sac shrinkage was 7.8 for occluded IMA and 3.9 for two or less patent LAs.Conclusion: The possibility of sac shrinkage would be high for the patient with occluded IMA and two or less patent LA at the end of EVAR, and that patient received TXA after EVAR. (This is a translation of Jpn J Vasc Surg 2022; 31: 291–297.)</description><identifier>ISSN: 1881-641X</identifier><identifier>EISSN: 1881-6428</identifier><identifier>DOI: 10.3400/avd.avd.oa.23-00065</identifier><identifier>PMID: 38188976</identifier><language>eng</language><publisher>Japan: The Editorial Committee of Annals of Vascular Diseases</publisher><subject>aneurysm sac shrinkage ; antifibrinolytic therapy ; coil embolization ; endovascular abdominal aortic aneurysm repair ; tranexamic acid</subject><ispartof>Annals of Vascular Diseases, 2023, Vol.16(4), pp.245-252</ispartof><rights>2023 Annals of Vascular Diseases</rights><rights>@ 2023 The Editorial Committee of Annals of Vascular Diseases.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c362t-a66e0c7e876e870aed5f3a51598cec97227ea0906ddfbdc1a0c5aa7f8a499b13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,1877,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38188976$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aoki, Atsushi</creatorcontrib><creatorcontrib>Maruta, Kazuto</creatorcontrib><creatorcontrib>Masuda, Tomoaki</creatorcontrib><creatorcontrib>Omoto, Tadashi</creatorcontrib><title>Factors Influencing on the Aneurysm Sac Shrinkage after Endovascular Abdominal Aortic Aneurysm Repair by the Analysis of the Patients with the Aneurysm Sac Shrinkage and Expansion</title><title>Annals of Vascular Diseases</title><addtitle>Annals of Vascular Diseases</addtitle><description>Objectives: The aneurysmal sac shrinkage has been reported as the strong predictor of favorable long-term outcome after endovascular aneurysm repair (EVAR). We evaluated the effects of perioperative and intraoperative factors on the aneurysm sac shrinkage.Methods: EVAR was performed for 296 patients during August 2009–December 2021. Nine patients with type Ia, Ib, or III; 69 patients with the sac diameter change less than 5 mm; and five patients with sac re-expansion after shrunk more than 5 mm were excluded. Thus, patients with sac shrinkage 5 mm or more (79 patients, shrinkage group) and with sac expansion 5 mm or more (18 patients) were included in this study. Antifibrinolytic therapy with tranexamic acid (TXA) 1500 mg/day for 6 months after EVAR was introduced in March 2013 and patent aortic side branches were coil embolized during EVAR since July 2015. Patients’ background and patent aortic side branches at the end of EVAR were evaluated.Results: Univariate analysis for comparison between patients with sac shrinkage and sac expansion revealed that males (82.3% vs. 55.6%, p = 0.021), without antiplatelet therapy (40.5% vs. 66.7%, p = 0.044) and TXA (79.8% vs. 38.9%, p <0.001), were significantly associated with sac shrinkage. By multivariate analysis, the odds ratio of sac shrinkage was 11.7 for males, 0.1 for the patients on antiplatelet therapy, and 6.5 for the patient who received TXA. The patients with patent inferior mesenteric artery (IMA) were less in the shrinkage group (20.3% vs. 77.8%, p <0.001) and with two or less patent lumbar arteries (LAs) were more in the shrinkage group (82.3% vs. 33.3%, p < 0.001). The odd ratio of sac shrinkage was 7.8 for occluded IMA and 3.9 for two or less patent LAs.Conclusion: The possibility of sac shrinkage would be high for the patient with occluded IMA and two or less patent LA at the end of EVAR, and that patient received TXA after EVAR. (This is a translation of Jpn J Vasc Surg 2022; 31: 291–297.)</description><subject>aneurysm sac shrinkage</subject><subject>antifibrinolytic therapy</subject><subject>coil embolization</subject><subject>endovascular abdominal aortic aneurysm repair</subject><subject>tranexamic acid</subject><issn>1881-641X</issn><issn>1881-6428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kc9u1DAQxiNERUvLEyAhH7lksePEcY6raktXqgSiPfRmTexJ1yWxF9tp2efqC5L9wyJx6GHssfz7vpHmy7KPjM54SekXeDKzbXmYFTynlIrqTXbGpGS5KAv59tiz-9PsfYyPEyFEI99lp1xOX00tzrKXK9DJh0iWrutHdNq6B-IdSSskc4dj2MSB3IImt6tg3U94QAJdwkAWzvgniHrsIZB5a_xgHfRk7kOy-p_0B67BBtJuDo7Qb6KNxHe793dIFl2K5Nmm1asznSGL32tw0Xp3kZ100Ef8cLjPs7urxd3ldX7z7evycn6Tay6KlIMQSHWNshZTUUBTdRwqVjVSo27qoqgRaEOFMV1rNAOqK4C6k1A2Tcv4efZ5b7sO_teIManBRo19Dw79GFXRMCZLVtZiQvke1cHHGLBT62AHCBvFqNqGpaagduVBFVztwppUnw4DxnZAc9T8TWcClnvgMaZpC0cAtjvucWfIhCq3x3_mR0avICh0_A_-7LFs</recordid><startdate>2023</startdate><enddate>2023</enddate><creator>Aoki, Atsushi</creator><creator>Maruta, Kazuto</creator><creator>Masuda, Tomoaki</creator><creator>Omoto, Tadashi</creator><general>The Editorial Committee of Annals of Vascular Diseases</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2023</creationdate><title>Factors Influencing on the Aneurysm Sac Shrinkage after Endovascular Abdominal Aortic Aneurysm Repair by the Analysis of the Patients with the Aneurysm Sac Shrinkage and Expansion</title><author>Aoki, Atsushi ; Maruta, Kazuto ; Masuda, Tomoaki ; Omoto, Tadashi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-a66e0c7e876e870aed5f3a51598cec97227ea0906ddfbdc1a0c5aa7f8a499b13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>aneurysm sac shrinkage</topic><topic>antifibrinolytic therapy</topic><topic>coil embolization</topic><topic>endovascular abdominal aortic aneurysm repair</topic><topic>tranexamic acid</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aoki, Atsushi</creatorcontrib><creatorcontrib>Maruta, Kazuto</creatorcontrib><creatorcontrib>Masuda, Tomoaki</creatorcontrib><creatorcontrib>Omoto, Tadashi</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of Vascular Diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aoki, Atsushi</au><au>Maruta, Kazuto</au><au>Masuda, Tomoaki</au><au>Omoto, Tadashi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors Influencing on the Aneurysm Sac Shrinkage after Endovascular Abdominal Aortic Aneurysm Repair by the Analysis of the Patients with the Aneurysm Sac Shrinkage and Expansion</atitle><jtitle>Annals of Vascular Diseases</jtitle><addtitle>Annals of Vascular Diseases</addtitle><date>2023</date><risdate>2023</risdate><volume>16</volume><issue>4</issue><spage>245</spage><epage>252</epage><pages>245-252</pages><artnum>avd.oa.23-00065</artnum><issn>1881-641X</issn><eissn>1881-6428</eissn><abstract>Objectives: The aneurysmal sac shrinkage has been reported as the strong predictor of favorable long-term outcome after endovascular aneurysm repair (EVAR). We evaluated the effects of perioperative and intraoperative factors on the aneurysm sac shrinkage.Methods: EVAR was performed for 296 patients during August 2009–December 2021. Nine patients with type Ia, Ib, or III; 69 patients with the sac diameter change less than 5 mm; and five patients with sac re-expansion after shrunk more than 5 mm were excluded. Thus, patients with sac shrinkage 5 mm or more (79 patients, shrinkage group) and with sac expansion 5 mm or more (18 patients) were included in this study. Antifibrinolytic therapy with tranexamic acid (TXA) 1500 mg/day for 6 months after EVAR was introduced in March 2013 and patent aortic side branches were coil embolized during EVAR since July 2015. Patients’ background and patent aortic side branches at the end of EVAR were evaluated.Results: Univariate analysis for comparison between patients with sac shrinkage and sac expansion revealed that males (82.3% vs. 55.6%, p = 0.021), without antiplatelet therapy (40.5% vs. 66.7%, p = 0.044) and TXA (79.8% vs. 38.9%, p <0.001), were significantly associated with sac shrinkage. By multivariate analysis, the odds ratio of sac shrinkage was 11.7 for males, 0.1 for the patients on antiplatelet therapy, and 6.5 for the patient who received TXA. The patients with patent inferior mesenteric artery (IMA) were less in the shrinkage group (20.3% vs. 77.8%, p <0.001) and with two or less patent lumbar arteries (LAs) were more in the shrinkage group (82.3% vs. 33.3%, p < 0.001). The odd ratio of sac shrinkage was 7.8 for occluded IMA and 3.9 for two or less patent LAs.Conclusion: The possibility of sac shrinkage would be high for the patient with occluded IMA and two or less patent LA at the end of EVAR, and that patient received TXA after EVAR. (This is a translation of Jpn J Vasc Surg 2022; 31: 291–297.)</abstract><cop>Japan</cop><pub>The Editorial Committee of Annals of Vascular Diseases</pub><pmid>38188976</pmid><doi>10.3400/avd.avd.oa.23-00065</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; J-STAGE (Japan Science & Technology Information Aggregator, Electronic) Freely Available Titles - Japanese; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | aneurysm sac shrinkage antifibrinolytic therapy coil embolization endovascular abdominal aortic aneurysm repair tranexamic acid |
| title | Factors Influencing on the Aneurysm Sac Shrinkage after Endovascular Abdominal Aortic Aneurysm Repair by the Analysis of the Patients with the Aneurysm Sac Shrinkage and Expansion |
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