Clinical comparison of two different types of bifurcated graft for postoperative baPWV and ABI.
OBJECTIVE
A newly-designed bifurcated graft with the distal end larger than the conventional type has been developed. The purpose of this study was to evaluate the early results of graft replacement using this new graft, and to compare whether the new graft is more advantageous than the conventional graft in terms of peripheral blood flow and arterial stiffness.


METHODS
Records of 36 patients who underwent bifurcated graft replacement for infrarenal abdominal aortic aneurysm (AAA), from May 2003 to September 2006 were reviewed after excluding peripheral arterial disease (ABI > 0.9). Subjects were divided into two groups: group C (N.=20), with implantation of the conventional type and group N (N.=16), with implantation of the new type. We investigated changes in brachial-ankle pulse wave velocity (baPWV) and ankle-brachial pressure index (ABI), measurements being performed preoperatively and postoperatively.


RESULTS
baPWV in the postoperative group as a whole was significantly higher than in the preoperative group (P<0.05), while ABI in the postoperative group was lower than in the preoperative group (P<0.05). In group C, baPWV increased (P<0.05) and ABI decreased (P<0.05) after bifurcated graft replacement, whereas in group N, there were no significant differences in changes of baPWV and ABI.


CONCLUSIONS
This study shows that the new graft reduces the development of arterial stiffness postoperatively compared with the conventional type. These results may predict the new type graft decrease in the risk of morbidity and mortality caused by atherosclerotic disease.
Iwahashi
T
T
Second Department of Surgery, Tokyo Medical University Hospital, Tokyo, Japan.
Obitsu
Y
Y
Koizumi
N
N
Shiraishi
Y
Y
Shigematsu
H
H
D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D017544:Aortic Aneurysm, Abdominal / Q000503:physiopathology / Q000601:surgery*; D001783:Blood Flow Velocity; D001794:Blood Pressure; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D016009:Chi-Square Distribution; D004548:Elasticity; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010991:Plethysmography; D011474:Prosthesis Design; D012039:Regional Blood Flow; D013997:Time Factors; D016896:Treatment Outcome