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Correlation Between Calcium Scoring and Abdominal Aortic Aneurysm Endovascular Repair Outcomes

Houssam Farres1, Santh Prakash Lanka1, Sam Nussbaum2

  • 1Division of Vascular Surgery, Mayo Clinic, Jacksonville, FL, USA.

Vascular and Endovascular Surgery
|June 17, 2024
PubMed

Insights

Higher vascular calcium burden, measured by the Agatston score, is linked to decreased survival after endovascular aneurysm repair and increased risk of type 2 endoleaks. This scoring system can predict mortality risk in patients undergoing this procedure.

Area of Science:

  • Vascular Surgery
  • Radiology
  • Cardiovascular Research

Background:

  • Endovascular aneurysm repair (EVAR) offers lower perioperative risks but faces challenges with long-term reintervention rates due to endoleaks.
  • Vascular calcium burden is an emerging factor influencing EVAR outcomes.
  • The Agatston scoring system provides a standardized method for quantifying vascular calcification.

Purpose of the Study:

  • To investigate the association between vascular calcium burden, quantified by the Agatston score, and outcomes following EVAR.
  • To determine if calcium burden predicts mortality and endoleak development after EVAR.

Main Methods:

  • Retrospective analysis of 87 patients who underwent EVAR between 2008 and 2020.
  • Preoperative non-contrast computed tomography scans were used to calculate the Agatston calcium score.
  • Outcomes assessed included mortality and the presence of endoleaks.

Main Results:

  • Patients with higher median total calcium scores (≥12966.9) exhibited significantly lower five-year survival rates (52.3%) compared to those with lower scores (<12966.9) (79.8%, P = .002).
  • A significant association was found between higher calcium scores above the aneurysm level and the occurrence of type 2 endoleaks (1591.2 vs 688.2, P = .05).

Conclusions:

  • The Agatston calcium score is a valuable predictor of mortality risk in patients undergoing EVAR.
  • Utilizing calcium scoring can aid in treatment decision-making for EVAR patients.
  • Vascular calcification assessment may help stratify risk and guide management strategies.
Abstract

Keywords:
abdominal aortic aneurysmagatston systemcalcium scoreendovascular aneurysm repair

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