title: Intraoperative sac pressure measurement during endovascular abdominal aortic aneurysm repair.
abstract: OBJECTIVE
  Intraoperative sac pressure was measured during endovascular abdominal aortic aneurysm repair (EVAR) to evaluate the clinical significance of sac pressure measurement.
  
  
  METHODS
  A microcatheter was placed in an aneurysm sac from the contralateral femoral artery, and sac pressure was measured during EVAR procedures in 47 patients. Aortic blood pressure was measured as a control by a catheter from the left brachial artery.
  
  
  RESULTS
  The systolic sac pressure index (SPI) was 0.87 +/- 0.10 after main-body deployment, 0.63 +/- 0.12 after leg deployment (P < 0.01), and 0.56 +/- 0.12 after completion of the procedure (P < 0.01). Pulse pressure was 55 +/- 21 mmHg, 23 +/- 15 mmHg (P < 0.01), and 16 +/- 12 mmHg (P < 0.01), respectively. SPI showed no significant differences between the Zenith and Excluder stent grafts (0.56 +/- 0.13 vs. 0.54 +/- 0.10, NS). Type I endoleak was found in seven patients (15%), and the SPI decreased from 0.62 +/- 0.10 to 0.55 +/- 0.10 (P = 0.10) after fixing procedures. Type II endoleak was found in 12 patients (26%) by completion angiography. The SPI showed no difference between type II endoleak positive and negative (0.58 +/- 0.12 vs. 0.55 +/- 0.12, NS). There were no significant differences between the final SPI of abdominal aortic aneurysms in which the diameter decreased in the follow-up and that of abdominal aortic aneurysms in which the diameter did not change (0.53 +/- 0.12 vs. 0.57 +/- 0.12, NS).
  
  
  CONCLUSIONS
  Sac pressure measurement was useful for instant hemodynamic evaluation of the EVAR procedure, especially in type I endoleaks. However, on the basis of this small study, the SPI cannot be used to reliably predict sac growth or regression.
authors: Department of Vascular Surgery, Aichi Medical University Hospital, Nagakute, Aichi, Japan. ishibash@aichi-med-u.ac.jp
authors: Hiroyuki
authors: H
authors: Ishibashi
authors: Tsuneo
authors: T
authors: Ishiguchi
authors: Takashi
authors: T
authors: Ohta
authors: Ikuo
authors: I
authors: Sugimoto
authors: Hirohide
authors: H
authors: Iwata
authors: Tetsuya
authors: T
authors: Yamada
authors: Masao
authors: M
authors: Tadakoshi
authors: Noriyuki
authors: N
authors: Hida
authors: Yuki
authors: Y
authors: Orimoto
authors: Seiji
authors: S
authors: Kamei
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D017130:Angioplasty / Q000295:instrumentation / Q000379:methods*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001795:Blood Pressure Determination; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D057867:Endoleak / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D011474:Prosthesis Design; D018570:Risk Assessment; D013997:Time Factors; D014160:Transducers, Pressure; D016896:Treatment Outcome