title: Abdominal aortic aneurysm calcification and thrombus volume are not associated with outcome following endovascular abdominal aortic aneurysm repair.
abstract: OBJECTIVE
  Aortic calcification and thrombus have been postulated to worsen outcome following endovascular abdominal aortic aneurysm repair (EVAR). The purpose of this study was to assess the association of abdominal aortic aneurysm (AAA) calcification and thrombus volume with outcome following EVAR using a reproducible, quantifiable computed tomography (CT) assessment protocol.
  
  
  METHODS
  Patients with elective EVAR performed between January 2002 and 2012 at the Townsville Hospital, Mater Private Hospital (Townsville) and Royal Brisbane and Women's Hospital (RBWH) were included if preoperative CTAs were available for analysis. AAA calcification and thrombus volume were measured using a semiautomated workstation protocol. Outcomes were assessed in terms of clinical failure, endoleak (type I, type II) and reintervention. Univariate and multivariate analyses were performed. Median follow-up was 1.7 years and the interquartile range 1.0-3.8 years.
  
  
  RESULTS
  One hundred thirty-four patients undergoing elective EVAR were included in the study. Rates of primary clinical success and freedom from reintervention were 82.8% and 88.9% at the 24-month follow-up. AAA calcification and thrombus volume were not associated with clinical failure, type I endoleak, type II endoleak or reintervention.
  
  
  CONCLUSIONS
  AAA calcification and thrombus volume were not associated with poorer outcome after EVAR in this study.
  
  
  CONCLUSIONS
  • The association of calcification and thrombus volumes with EVAR outcome is unclear • Quantifiable methods for assessing calcification and thrombus were not used previously • This study used reproducible methods for assessing AAA calcification and thrombus volumes.
authors.affiliation: Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia, 4811.
authors.forename: Divyajeet
authors.initials: D
authors.lastname: Rai
authors.forename: Brendan
authors.initials: B
authors.lastname: Wisniowski
authors.forename: Barbara
authors.initials: B
authors.lastname: Bradshaw
authors.forename: Ramesh
authors.initials: R
authors.lastname: Velu
authors.forename: Patrik
authors.initials: P
authors.lastname: Tosenovsky
authors.forename: Francis
authors.initials: F
authors.lastname: Quigley
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Walker
authors.forename: Jonathan
authors.initials: J
authors.lastname: Golledge
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery; D001807:Blood Vessel Prosthesis; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000209:etiology; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography / Q000379:methods*; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology; D013997:Time Factors