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The sac shrinking process after EAR does not start immediately in most patients
M Prinssen1, J D Blankensteijn
1Department of Vascular and Transplantation Surgery (G04.228), University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
Summary
A logarithmic model accurately describes aneurysm shrinkage after endovascular aneurysm repair (EAR), with most patients showing a delay before shrinkage begins. This finding is crucial for understanding post-procedure recovery.
Area of Science:
- Vascular Surgery
- Medical Imaging Analysis
- Biomedical Engineering
Background:
- Endovascular aneurysm repair (EAR) is a common treatment for aortic aneurysms.
- Monitoring aneurysm sac shrinkage is vital for assessing treatment success.
- Predictive models for post-EAR sac behavior are needed.
Purpose of the Study:
- To evaluate logarithmic, exponential, and linear models for describing aneurysm sac shrinkage post-EAR.
- To determine if a lag time exists before shrinkage commences.
- To identify the best-fitting model for sac volume changes.
Main Methods:
- A cohort of 29 patients with complete 2-year CTA follow-up after EAR was analyzed.
- Thrombus volume was measured postoperatively and at 6, 12, and 24 months.
- Logarithmic, exponential, and linear models, with and without lag time, were fitted to the data.
Main Results:
- A logarithmic model provided the best fit for aneurysm sac shrinkage in 27 of 29 patients (correlation coefficient >0.95).
- A lag time to shrinkage was observed in 22 patients (median 63.4 days).
- Immediate sac shrinkage (<11%) was rare, with most patients exhibiting a delayed response.
Conclusions:
- A logarithmic function effectively models post-EAR aneurysm sac shrinkage.
- A significant lag time precedes shrinkage in the majority of patients.
- Early shrinkage after EAR is uncommon, emphasizing the importance of delayed volumetric changes.