title: Endovascular Aneurysm Repair Increases Aortic Arterial Stiffness When Compared to Open Repair of Abdominal Aortic Aneurysms.
abstract: OBJECTIVE
  The initial survival advantage seen with endovascular aneurysm repair (EVAR) over open repair does not persist in the long term. Pulse wave velocity (PWV) is a measure of arterial stiffness, and increased PWV is an independent risk factor for increased cardiovascular morbidity and mortality. This prospective comparative pilot study examined the effect of implantation of an aortic graft on PWV in patients undergoing open or endovascular aortic aneurysm repair.
  
  
  METHODS
  Thirty-four patients (15 open and 19 EVAR) were recruited. Patient demographics were similar in both the groups. Pulse wave velocity was calculated for all patients preoperatively and postoperatively using a standardized technique on a Philips IU22 Vascular Ultrasound machine and the results compared.
  
  
  RESULTS
  An increase in mean PWV following EVAR was demonstrated. The mean postprocedure PWV of 9.7 (± 4.5) cm/sec detected in the open group was significantly lower than the elevated 12.2 (± 4.5) cm/sec detected in the EVAR group. The surgical group also demonstrated a mean decrease of 0.2 (± 4.9) cm/sec in PWV following open repair compared to a mean increase of 3.3 (± 3.7) cm/sec in the EVAR group.
  
  
  CONCLUSIONS
  EVAR patients have a significantly higher postoperative PWV measurement than those undergoing open abdominal aortic aneurysm repair. Patients who have undergone EVAR may be at a higher risk of cardiovascular morbidity in the long term. A larger scale study with a longer prospective follow-up is required.
authors.affiliation: Department of Vascular Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
authors.forename: Cleona
authors.initials: C
authors.lastname: Gray
authors.affiliation: School of Physics, Dublin Institute of Technology, Dublin, Ireland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Goodman
authors.affiliation: Department of Vascular Surgery, Mater Misericordiae University Hospital, Dublin, Ireland stephenbadger@btinternet.com.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Badger
authors.affiliation: Department of Vascular Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
authors.forename: M Kevin
authors.initials: MK
authors.lastname: O'Malley
authors.affiliation: Department of Vascular Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
authors.forename: Martin K
authors.initials: MK
authors.lastname: O'Donohoe
authors.affiliation: Department of Vascular Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
authors.forename: Ciarán O
authors.initials: CO
authors.lastname: McDonnell
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D059289:Vascular Stiffness
keywords: abdominal aortic aneurysm; endovascular aneurysm repair; open aneurysm repair; pulse wave velocity