Evaluation of aortic stiffness (aortic pulse-wave velocity) before and after elective abdominal aortic aneurysm repair procedures: a pilot study.
BACKGROUND
The main clinical criterion for abdominal aortic aneurysm (AAA) repair operations is an AAA diameter >/=5.5 cm. When AAAs increase in size, specific changes occur in the mechanical properties of the aortic wall. Pulse-wave velocity (PWV) has been used as an indicator of vascular stiffness. A low PWV may predict AAA rupture risk and is an early predictor of cardiovascular mortality.


METHODS
We investigated the prognostic value of PWV before and after elective AAA repair procedures. Twenty four patients scheduled for an open AAA repair underwent a preoperative carotid-femoral aortic PWV measurement. A second aortic PWV measurement was carried out 6 months postoperatively.


RESULTS
The mean aortic PWV increased from 7.84 +/- 1.85 preoperatively to 10.08 +/- 1.57 m/sec 6 months postoperatively (mean change: 2.25; 95% confidence interval 1.4 to 3.1 m/sec; p<0.0001). The preprocedural PWV measurement did not correlate with AAA diameter (Spearman's rank correlation coefficient rho=0.12; p=0.59).


CONCLUSIONS
Whether the increase in aortic PWV postoperatively suggests a decreased cardiovascular risk following AAA repair remains to be established. Aortic PWV should also be investigated as an adjunct tool for assessing AAA rupture risk.
Paraskevas
Kosmas I
KI
Department of Vascular Surgery, Red Cross Hospital, Athens, Greece.
Bessias
Nikolaos
N
Psathas
Chrysovalantis
C
Akridas
Konstantinos
K
Dragios
Theodoros
T
Nikitas
Georgios
G
Andrikopoulos
Vassilios
V
Mikhailidis
Dimitri P
DP
Kyriakides
Zenon S
ZS