title: Volumetric analysis of aneurysm thrombosis after thoracic endovascular aortic repair predicts postoperative changes in platelet count and coagulation parameters.
abstract: BACKGROUND
  The aim of this study was to investigate the predictors of blood count changes and coagulation parameters alterations after thoracic aortic endovascular repair (TEVAR).
  
  
  METHODS
  Fifty patients (41 males, age 72±7 years) submitted between 2007 and 2009 to elective TEVAR for non-dissecting aortic lesions, without major associated surgical procedures, were analyzed. Blood count and coagulation parameters were recorded pre-operatively and daily up to postoperative day 5. The volume of new thrombus formed after TEVAR (TV) was calculated comparing pre- and post-operative computed tomography scans with a semi-automatic method by two independent examiners. Pre- intra-, and postoperative variables, including TV, were tested for a possible effect on changes in laboratory values and transfusion requirements using a stepwise multiple regression model analysis.
  
  
  RESULTS
  In the multivariable model, TV and associated surgical procedures were significantly associated with maximum platelets decrease (P=0.021, and P=0.029, respectively), while only TV remained a significant predictor for maximum prothrombin time increase (P=0.003). Maximum aneurysm diameter (P=0.041), procedural time (P=0.027), and TV (P=0.047) were also significant predictors of transfusion requirement.
  
  
  CONCLUSIONS
  TEVAR is associated with consumption of platelets and coagulative factors, which seems to be associated with the amount of perioperative aneurysm thrombosis. The latter may also help to predict perioperative transfusion requirement.
authors.affiliation: Department of Vascular Surgery, San Raffaele Scientific Institute, &quot;Vita-Salute&quot; University School of Medicine, Milan, Italy - kahlberg.andrea@hsr.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Kahlberg
authors.affiliation: Department of Vascular Surgery, San Raffaele Scientific Institute, &quot;Vita-Salute&quot; University School of Medicine, Milan, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Rinaldi
authors.affiliation: Department of Vascular Surgery, San Raffaele Scientific Institute, &quot;Vita-Salute&quot; University School of Medicine, Milan, Italy.
authors.forename: Yamume
authors.initials: Y
authors.lastname: Tshomba
authors.affiliation: Department of Vascular Surgery, San Raffaele Scientific Institute, &quot;Vita-Salute&quot; University School of Medicine, Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Spelta
authors.affiliation: Department of Vascular Surgery, San Raffaele Scientific Institute, &quot;Vita-Salute&quot; University School of Medicine, Milan, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Mascia
authors.affiliation: Department of Vascular Surgery, San Raffaele Scientific Institute, &quot;Vita-Salute&quot; University School of Medicine, Milan, Italy.
authors.forename: Germano
authors.initials: G
authors.lastname: Melissano
authors.affiliation: Department of Vascular Surgery, San Raffaele Scientific Institute, &quot;Vita-Salute&quot; University School of Medicine, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Chiesa
mesh_terms: D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods*; D001777:Blood Coagulation; D016063:Blood Loss, Surgical; D001792:Blood Platelets; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D010976:Platelet Count; D019106:Postoperative Hemorrhage / Q000097:blood / Q000209:etiology; D011237:Predictive Value of Tests; D011517:Prothrombin Time; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome