title: Calcium channel blockers enhance sac shrinkage after endovascular aneurysm repair.
abstract: OBJECTIVE
  Sac shrinkage is a surrogate marker of success after endovascular aneurysm repair (EVAR). We set out to determine if any common cardioprotective medications had a beneficial effect on sac shrinkage.
  
  
  METHODS
  This retrospective observational study took place at Leeds Vascular Institute, a tertiary vascular unit in the Northern United Kingdom. The cohort comprised 149 patients undergoing EVAR between January 1, 2005, and December 31, 2008. Medication use was recorded at intervention (verified at study completion in 33 patients), and patients were monitored for 2 years. The main outcome measures were the effect of medication on sac shrinkage as determined by percentage change in maximal idealized cross-sectional area of the aneurysm at 1 month, 6 months, 1 year, and 2 years by linear regression model, in addition to 2-year endoleak and death rates determined by a binary logistic regression model.
  
  
  RESULTS
  After exclusions, 112 patients, who were a median age of 78 years (interquartile range, 78-83 years), remained for analysis. The median Glasgow Aneurysm Score was 85 (interquartile range, 79-92). At 2 years, mortality was 13.4%, endoleak developed in 37.5%, and significant endoleak developed in 14.3%. Patients taking a calcium channel blocker had enhanced sac shrinkage, compared with those not taking a calcium channel blocker, by 6.6% at 6 months (-3.0% to 16.3%, P = .09), 12.3% at 1 year (2.9% to 21.7%, P = .008), and 13.1% at 2 years (0.005% to 26.2%, P = .007) independent of other medication use, graft type, endoleak development, or death.
  
  
  CONCLUSIONS
  Enhanced sac shrinkage occurred after EVAR in patients taking calcium channel blockers. This warrants further study in other centers and at the molecular level.
authors.affiliation: Leeds Vascular Institute, the General Infirmary at Leeds, Leeds, United Kingdom. marc.bailey@doctors.org.uk
authors.forename: Marc A
authors.initials: MA
authors.lastname: Bailey
authors.forename: Soroush
authors.initials: S
authors.lastname: Sohrabi
authors.forename: Karen
authors.initials: K
authors.lastname: Flood
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Griffin
authors.forename: S Tawqeer
authors.initials: ST
authors.lastname: Rashid
authors.forename: Anne B
authors.initials: AB
authors.lastname: Johnson
authors.forename: Paul D
authors.initials: PD
authors.lastname: Baxter
authors.forename: Jai V
authors.initials: JV
authors.lastname: Patel
authors.forename: D Julian A
authors.initials: DJ
authors.lastname: Scott
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D057867:Endoleak / Q000209:etiology; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D004739:England; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012042:Registries; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D002121:Calcium Channel Blockers