title: Statins promote residual aneurysm sac regression following endovascular aortic aneurysm repair.
abstract: BACKGROUND
  Regression of the residual sac is indicative of successful endovascular aortic aneurysm (EVAR) repair. Using color duplex ultrasound (CDU), we monitored the residual aneurysm sac following EVAR and correlated sac behavior with perioperative risk factors.
  
  
  METHODS
  Of 145 patients with EVAR, 106 (73.1%) patients between January 01, 2003, and July 01, 2010, had at least 2 consecutive postoperative scans and thus were eligible for inclusion. Mean (± standard deviation [SD]) CDU scans per person was 4.6 (± 1.4). All were conducted by the same technologist using a standard protocol on the same machine. Aneurysm sac change in centimeters and percentage terms was calculated. The presence or absence of an endoleak was also recorded. Change in aneurysm sac size was correlated with preoperative risk factors.
  
  
  RESULTS
  Mean sac size change at 1 month was a decrease of 0.24 cm, equating to a percentage change of 4.3%. At 7 months, the decrease was 0.59 cm (9.8%), at 12 months, 0.73 cm (12.4%), at 18 months 0.92 cm (15.8%), and at 36 months 1.0 cm (16.6%). Both univariate and multivariate analyses demonstrated that statin therapy (P = .002) was the only risk factor variable positively associated with aneurysm regression while the presence of an endoleak was inversely related to sac reduction (P = .01).
  
  
  CONCLUSIONS
  Maximum aneurysmal sac reduction seems to occur in the first year following endograft implantation. Statin therapy appears to be associated with an increased likelihood of sac regression following EVAR. Further investigation of the role of statins in the biology of abdominal aortic aneurysmal disease is warranted.
authors.affiliation: 1Department of Vascular Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
authors.forename: Cleona
authors.initials: C
authors.lastname: Gray
authors.forename: Patrick
authors.initials: P
authors.lastname: Goodman
authors.forename: M Kevin
authors.initials: MK
authors.lastname: O'Malley
authors.forename: Martin K
authors.initials: MK
authors.lastname: O'Donohoe
authors.forename: Ciarán O
authors.initials: CO
authors.lastname: McDonnell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D057867:Endoleak / Q000209:etiology; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: EVAR; aorta; statin