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Preexisting thrombus and aortic aneurysm size change after endovascular repair
1Division of Vascular Surgery, Department of Surgery, Northwestern University Medical School, Chicago, Illinois, 60611, USA. j-matsumura@nwu.edu
Background:
Recent studies have demonstrated the effectiveness of endovascular grafting with aneurysm shrinkage following total exclusion of the abdominal aortic aneurysm (AAA). However, little is known about the effect of the preexisting thrombus (PT) on changes in aneurysm size following endovascular grafting. Therefore, this study is designed to determine the effect of PT on aneurysm size following endovascular grafting.
Methods:
Blinded measurements of preoperative, postoperative, and 1-year computed tomographic scans of 44 patients undergoing endovascular grafting for AAA were performed. PT fraction was determined by the formula This was normalized for preoperative AAA growth. Pearson correlations were performed with AAA minor diameter change over the first year.
Results:
There was no statistically significant relationship between PT fraction and rate of aneurysm size change (all patients, r = 0. 196 and P = 0.207). When patients with persistent leaks were excluded, the r = 0.234 and P = 0.170 also were not statistically significant.
Conclusions:
The amount of PT bears no important relationship to the response of the aneurysm following endovascular repair. Failure of aneurysms to shrink after endovascular treatment should not be attributed to large PT, but should prompt a thorough investigation for incomplete exclusion of the AAA. Long-term studies are needed to validate the efficacy of this new form of treatment.