Endoleak after endovascular graft repair of experimental aortic aneurysms: does coil embolization with angiographic "seal" lower intraaneurysmal pressure?
Détails
ID Serval
serval:BIB_3922C865C569
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Endoleak after endovascular graft repair of experimental aortic aneurysms: does coil embolization with angiographic "seal" lower intraaneurysmal pressure?
Périodique
Journal of Vascular Surgery
ISSN
0741-5214 (Print)
Statut éditorial
Publié
Date de publication
03/1998
Volume
27
Numéro
3
Pages
454-61; discussion 462
Notes
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S. --- Old month value: Mar
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S. --- Old month value: Mar
Résumé
PURPOSE: To investigate the relation between endoleaks and intraaneurysmal pressure (IAP) and the effect of coil embolization in the management of endoleaks. METHODS: The infrarenal aorta of a dog (n = 15) was replaced by a polytetrafluoroethylene aneurysm containing a pressure transducer. Group I (n = 4) had untreated aneurysms. Group II (n = 4) had endovascularly excluded aneurysms without an endoleak. Group III (n = 7) had aneurysms excluded by means of grafts with a defect that represented the source of an endoleak. After 4 weeks of follow-up study, the endoleaks in group III dogs were subjected to coil embolization. Systolic IAP was measured daily and expressed as a ratio of systolic blood pressure obtained from a forelimb cuff. Arteriography, duplex ultrasonography, and spiral contrast computed tomography were performed to evaluate endoleaks. RESULTS: In group I, the LAP remained close to systolic blood pressure (ratio of 0.96 +/- 0.06), whereas in group II the IAP ratio showed a decline to 0.34 +/- 0.16 (p = 0.0009 group I versus II). After an initial decrease, the IAP ratio in group III stabilized at 0.75 +/- 0.18 (p = 0.003, group II versus III). Aneurysms with an endoleak remained pulsatile with a pulse pressure of 30 +/- 16 mm Hg, which was less than that of untreated aneurysms (62 +/- 15 mm Hg; p < 0.0001 group I versus III). Arteriography and computed tomography revealed "sealing" of endoleaks after coil embolization, but IAP ratio did not decrease (0.76 +/- 0.14) after coil embolization. CONCLUSIONS: Incomplete endovascular aneurysm exclusion caused by an endoleak fails to reduce IAP ratio and may subject the aneurysm to a continued risk for rupture. Although coil embolization resulted in angiographic and computed tomographic sealing, it failed to reduce IAP ratio.
Mots-clé
Aneurysm, False/diagnosis/etiology/physiopathology/*therapy
Angiography
Animals
Aortic Aneurysm/*surgery
Blood Pressure
Blood Vessel Prosthesis Implantation/*adverse effects
Disease Models, Animal
Dogs
Embolization, Therapeutic/*methods
Female
Stents
Tomography, X-Ray Computed
Ultrasonography, Doppler, Duplex
Pubmed
Web of science
Open Access
Oui
Création de la notice
28/01/2008 10:31
Dernière modification de la notice
20/08/2019 14:28