title: Follow-up of aneurysm neck diameter after endovascular repair of abdominal aortic aneurysms.
abstract: We assessed aneurysm neck diameter change after endovascular abdominal aortic aneurysm repair (EVAR) and its relationship to stent-graft diameter. Ninety-eight patients with abdominal aortic aneurysm who underwent EVAR were studied with multislice computed tomography following a standardized protocol. A preoperative study and immediate postoperative, 6-month, 1-year, and 2-year follow-up studies were performed. The aneurysm neck was measured from adventitia to adventitia, 6 mm below the lowermost renal artery, in planar images performed perpendicular to the vessel axis (real axial section). Baseline and follow-up neck diameters were compared with stent-graft diameters. For statistical analysis, a one-way analysis of variance with repeated measures was used. Pearson's correlation coefficient was used to examine the correlation between the change in neck diameter and stent-graft diameter. The average neck diameter was 22.38 mm (range 16-32.5) on the preoperative study and 23.35 mm (17-33.9) on the immediate postoperative, 24.35 mm (18.2-34.5) on the 6-month, 24.36 mm (18-34.5) on the 1-year, and 24.39 mm (17.8-35.7) on the 2-year follow-up. The mean device diameter was 24.08 mm (20-32). A significant increase in average neck diameter was found between the preoperative, immediate postoperative control, and 6-month control. There was no significant increase in the average neck diameter between the 6-month, 1-year, and 2-year follow-up. Baseline mean stent-graft oversizing was 1.7 mm, which decreased to -0.31 mm at latest follow-up. Dilation of the neck did not significantly exceed the endograft diameter in 83 cases (87.36%). An enlargement of the infrarenal aneurysm neck occurred during the first 6 months after EVAR. No significant variation in neck diameter occurred between the 6-month and 2-year follow-up visits. In the majority of cases, dilation of the aneurysm neck does not significantly exceed stent-graft diameter and, therefore, is possibly related to the presence of the endograft.
authors.affiliation: Department of Radiology, University Hospital La Paz, Madrid, Spain.
authors.forename: Alberto Bravo
authors.initials: AB
authors.lastname: Soberón
authors.forename: Milagros Martí
authors.initials: MM
authors.lastname: de Garcia
authors.forename: Gonzalo Garzón
authors.initials: GG
authors.lastname: Möll
authors.forename: Beatriz Rodríguez
authors.initials: BR
authors.lastname: Vigil
authors.forename: María Allona
authors.initials: MA
authors.lastname: Krauel
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Alvarez-Sala Walter
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D014057:Tomography, X-Ray Computed