title: Utility of noninvasive aneurysm sac pressure measurement during and after endovascular abdominal aortic aneurysm repair.
abstract: OBJECTIVE
  The utility of noninvasive pressure sensors in the intra- and postoperative settings is not entirely clear. The objectives of this study were to determine intraoperative pressure criteria in the setting of technically successful endovascular aneurysm repair (EVAR) and to evaluate pressure changes during follow-up.
  
  
  METHODS
  A total of 55 patients (42 men) underwent attempted noninvasive sensor monitor placement within the aneurysm sac. Pressures were recorded before and after EVAR. Recordings were repeated at 1 day, 2 weeks, 3 months, and 1 year. Clinical data, pressure recordings, and computed tomography were retrospectively assessed.
  
  
  RESULTS
  Noninvasive pressure sensors were successfully placed in 51 patients. The mean intraoperative decreases in pulse pressure (PP) and PP ratio (PPR) in the setting of technical success were statistically different versus (i) baseline recordings and (ii) pressures obtained in the setting of type I endoleak (74.2% vs 41.5% and 76.2% vs 46.5%, respectively). At follow-up, there were continued decreases in PP and PPR, with a decrease in mean pressure resuming at the 3-month interval. Four of 14 type II endoleaks were treated because of relatively increased pressure with stable or increased aneurysm size.
  
  
  CONCLUSIONS
  An intraoperative decrease in PP and PPR in the range of approximately 70% after EVAR was associated with successful aneurysm exclusion. Noninvasive sensors can provide useful ancillary information in confirming technical success intraoperatively. During follow-up, an increase in sensor pressure recordings may be suggestive of clinically significant endoleak; however, further research is necessary.
authors.affiliation: Department of Interventional Radiology, Memorial Hospital of South Bend, 615 N Michigan St, South Bend, IN 46601-1033, USA. micjhall@hotmail.com
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hall
authors.forename: Gerard I
authors.initials: GI
authors.lastname: Duprat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000295:instrumentation*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D057867:Endoleak / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D007196:Indiana; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013686:Telemetry / Q000295:instrumentation*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014160:Transducers, Pressure; D016896:Treatment Outcome