title: Sonographic Changes in Optic Nerve Sheath Diameter Associated with Supra- versus Infrarenal Aortic Aneurysm Repair.
abstract: Quantification of changes in optic nerve sheath diameter (ONSD) using ocular sonography (OS) constitutes an elegant technique for estimating intracranial and intraspinal pressure. Aortic aneurysm repair (AAR) is associated with a reasonable risk of increased spinal fluid pressure, which is largely dependent on the extent of aneurysm repair (supra- vs. infrarenal). The aim of this study was to compare ONSD measurements in patients with suprarenal AAR (sAAR) or infrarenal AAR (iAAR).
  
  
  
  Thirty patients who underwent elective endovascular repair of infrarenal aortic aneurysms (Group iAAR) were included in the study; the characteristics in these cases were prospectively analyzed and compared with those in a previously investigated group of 28 patients treated for suprarenal aortic aneurysms (Group sAAR). Six measurements of ONSDs were performed in each patient at five consecutive time points. Statistical analysis was performed using the Wilcoxon test. A P value < .05 was considered statistically significant.
  
  
  
  A highly significant difference between pre- and postinterventional values could be detected in both patient groups (P < .01). In Group sAAR, there was a mean .3-mm increase of the ONSD, whereas in Group iAAR, a mean .2-mm decrease could be detected. Both groups roughly reached baseline values by the end of their inpatient stay.
  
  
  
  ONSD changes seem to be a reliable marker to estimate spinal perfusion. Since OS provides a suitable bedside tool for rapid reevaluation, it may guide physicians in the identification and treatment of patients at high risk for spinal cord ischemia.
authors.affiliation: Neurology Department, Klinikum Augsburg, Stenglinstr. 2, 86165, Augsburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Ertl
authors.affiliation: Department of Surgery, Vascular and Endovascular Surgery, University of Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany.
authors.forename: Wilma
authors.initials: W
authors.lastname: Schierling
authors.affiliation: Department of Surgery, Vascular and Endovascular Surgery, University of Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany.
authors.forename: Piotr M
authors.initials: PM
authors.lastname: Kasprzak
authors.affiliation: Department of Surgery, Vascular and Endovascular Surgery, University of Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kopp
authors.affiliation: Department of Surgery, Vascular and Endovascular Surgery, University of Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany.
authors.forename: Corinna
authors.initials: C
authors.lastname: Brückl
authors.affiliation: Neurology Department, University of Regensburg, Universitätsstraße 84, 93053, Regensburg, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Schlachetzki
authors.affiliation: Department of Surgery, Vascular and Endovascular Surgery, University of Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Pfister
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects*; D017544:Aortic Aneurysm, Abdominal / Q000503:physiopathology / Q000601:surgery*; D001837:Body Weights and Measures; D002404:Catheterization; D002555:Cerebrospinal Fluid / Q000502:physiology; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000000981:diagnostic imaging*; D011312:Pressure; D011446:Prospective Studies; D013116:Spinal Cord / Q000098:blood supply*; D020760:Spinal Cord Ischemia / Q000209:etiology / Q000503:physiopathology*; D014463:Ultrasonography
keywords: Optic nerve sheath diameter; aortic aneurysm repair; cerebrospinal fluid space; intraspinal pressure; spinal cord ischemia