Abdominal Aortic Aneurysm Volumetric Evaluation During Mid-term Follow-Up After Endovascular Sealing Using the Nellix™ Device
Objectives To analyze the volumetric evolution of abdominal aortic aneurysms after endovascular sealing (EVAS) with the Nellix™ device during follow-up. Methods Patients who underwent elective EVAS in our institution in 2014 and 2015 were retrospectively reviewed. Preoperative, postoperative and 1-year scans were processed. A custom software was conceived to assess semi-automated measurements of the aneurysm sac and the endograft sizes including volume, maximum diameter, sectional area and perimeter. Thrombus volume, aneurysm length, mean distance between the stents inside the polymer-filled sacs and endograft migration were also estimated. Manual maximum diameters were measured for comparison. Inter and intra-observer variability of the proposed semi-automated method was evaluated. Results Pre-EVAS, post-EVAS and last follow-up scans of 12 patients were finally analyzed during a mean follow-up of 17 ± 5 months. No endograft migration or endoleak were detected. During follow-up, aneurysm volume and perimeter slightly increased compared to post-EVAS scans (+ 1 and + 5%, respectively, p < 0.05). A systematic 6% enlargement of the endobag volume was also observed (range 1–15 mL, p < 0.001). Endobag maximum diameter, area and perimeter increased 4, 8, and 8%, respectively (all p < 0.01). Mean plane-by-plane distance between stents increased 4% (p < 0.05). Mean thrombus volume did not change during follow-up, although a high variability was observed. Aneurysm and thrombus volume changes were highly correlated (r = 0.93, p < 0.001). No associations were observed between aneurysm and endobag volume changes. Intra- and inter-observer variability was below 1.7 and 2.4% for diameter and volume measurements, respectively. The automated measurements of post-EVAS aneurysm diameter and volume were higher than preoperative (p < 0.05). Maximum diameters measured manually did not differ between scans. Conclusion Small aneurysm volume enlargement detected during a mid-term follow-up was associated with thrombus size change, whereas systematic endograft expansion resulted independent from the aortic growth. Volumetric measurements using a semi-automated method could quantify small changes in aneurysm, endograft and thrombus sizes not detected by manually defined maximal diameters..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
Cardiovascular engineering and technology - 10(2019), 1 vom: März, Seite 22-31 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
El Batti, Salma [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Abdominal aortic aneurysm |
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| doi: |
10.1007/s13239-018-00380-4 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC2028517158 |
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| 520 | |a Objectives To analyze the volumetric evolution of abdominal aortic aneurysms after endovascular sealing (EVAS) with the Nellix™ device during follow-up. Methods Patients who underwent elective EVAS in our institution in 2014 and 2015 were retrospectively reviewed. Preoperative, postoperative and 1-year scans were processed. A custom software was conceived to assess semi-automated measurements of the aneurysm sac and the endograft sizes including volume, maximum diameter, sectional area and perimeter. Thrombus volume, aneurysm length, mean distance between the stents inside the polymer-filled sacs and endograft migration were also estimated. Manual maximum diameters were measured for comparison. Inter and intra-observer variability of the proposed semi-automated method was evaluated. Results Pre-EVAS, post-EVAS and last follow-up scans of 12 patients were finally analyzed during a mean follow-up of 17 ± 5 months. No endograft migration or endoleak were detected. During follow-up, aneurysm volume and perimeter slightly increased compared to post-EVAS scans (+ 1 and + 5%, respectively, p < 0.05). A systematic 6% enlargement of the endobag volume was also observed (range 1–15 mL, p < 0.001). Endobag maximum diameter, area and perimeter increased 4, 8, and 8%, respectively (all p < 0.01). Mean plane-by-plane distance between stents increased 4% (p < 0.05). Mean thrombus volume did not change during follow-up, although a high variability was observed. Aneurysm and thrombus volume changes were highly correlated (r = 0.93, p < 0.001). No associations were observed between aneurysm and endobag volume changes. Intra- and inter-observer variability was below 1.7 and 2.4% for diameter and volume measurements, respectively. The automated measurements of post-EVAS aneurysm diameter and volume were higher than preoperative (p < 0.05). Maximum diameters measured manually did not differ between scans. Conclusion Small aneurysm volume enlargement detected during a mid-term follow-up was associated with thrombus size change, whereas systematic endograft expansion resulted independent from the aortic growth. Volumetric measurements using a semi-automated method could quantify small changes in aneurysm, endograft and thrombus sizes not detected by manually defined maximal diameters. | ||
| 650 | 4 | |a Abdominal aortic aneurysm |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Aneurysm sizing |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Endograft follow-up |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Aneurysm volume |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Endovascular sealing system |7 (dpeaa)DE-He213 | |
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| 700 | 1 | |a Latremouille, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Julia, Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Mousseaux, Elie |e verfasserin |4 aut | |
| 700 | 1 | |a Craiem, Damian |e verfasserin |4 aut | |
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