title: The Effect of Revascularization on the Hemodynamic Profile of Patients with Infrarenal Aortic Occlusion.
abstract: BACKGROUND
  Patients undergoing revascularization for infrarenal aortic occlusion (IAO) have been reported to present improved survival rates compared to those treated conservatively. Aim of this study was to investigate the hemodynamic changes induced after revascularization for IAO, as expressed with pulse wave velocity (PWV), augmentation index (Aix), augmentation pressure (AP), and pulse wave reflection coefficient (RC).
  
  
  METHODS
  Twelve patients underwent revascularization (9 aortobifemoral/aortobiiliac bypasses, 2 primary iliac stenting, and 1 hybrid procedure of unilateral aortoiliac stenting and crossover bypass). Calculation of hemodynamic parameters was performed in all patients preoperatively, at 1 month, and 1 year postoperatively. Pulse wave analysis was performed noninvasively with a novel validated brachial cuff-based automatic oscillometric device (Mobil-O-Graph; IEM, Stolberg, Germany). The estimated hemodynamic parameters were AIx, AP, RC, and PWV. Data were analyzed with the Friedman analysis of variance test.
  
  
  RESULTS
  Aix decreased significantly at 1 month and further at 1 year postoperatively compared to preoperative values (24 ± 11 and 17 ± 13 vs. 34 ± 13.5, respectively, P = 0.0006). AP decreased at 1 month and 1 year postoperatively compared to preoperative values (6.5 ± 4 mm Hg and 8 ± 6.5 mm Hg vs. 13 ± 12 mm Hg, respectively, P = 0.045). RC decreased also at 1-month and 1-year postoperatively compared to preoperative values (62 ± 5.5, 64 ± 4.3 vs. 73 ± 5.1, respectively, P = 0.002). However, changes in PWV were less prominent in this short-term postoperative period.
  
  
  CONCLUSIONS
  Improved hemodynamic profile may theoretically contribute to the enhanced survival rates of these patients.
authors.affiliation: Department of Vascular Surgery, "Democritus" University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Argyriou
authors.affiliation: Department of Vascular Surgery, "Democritus" University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece. Electronic address: efstratiosgeorg@gmail.com.
authors.forename: Efstratios
authors.initials: E
authors.lastname: Georgakarakos
authors.affiliation: Department of Vascular Surgery, "Democritus" University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
authors.forename: George S
authors.initials: GS
authors.lastname: Georgiadis
authors.affiliation: Department of Vascular Surgery, "Democritus" University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Schoretsanitis
authors.affiliation: Department of Vascular Surgery, "Democritus" University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
authors.forename: Miltos K
authors.initials: MK
authors.lastname: Lazarides
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D062186:Arterial Pressure; D001807:Blood Vessel Prosthesis; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis / Q000295:instrumentation; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects; D059289:Vascular Stiffness