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Abdominal aortic aneurysm calcification and thrombus volume are not associated with outcome following endovascular abdominal aortic aneurysm repair

  • Vascular-Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

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.

Key Points

• 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

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Abbreviations

AAA:

Abdominal aortic aneurysm

EVAR:

Endovascular aneurysm repair

ASA:

American Society of Anaesthesiology

CTA:

Computed tomography angiography

SVS:

Society for Vascular Surgery

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Acknowledgments

The scientific guarantor of this publication is Dr Divyajeet Rai. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has received funding: Funding from the Queensland Government, The Townsville Hospital and National Health and Medical Research Council supported this work. Jonathan Golledge (JG) holds a Practitioner Fellowships from the National Health and Medical Research Council, Australia (1019921). JG holds a Senior Clinical Research Fellowship from the Office of Health and Medical Research, Queensland. The authors have no conflicts of interest relevant to this article. Dr Petra Buettner and Prof. Jonathan Golledge kindly provided statistical advice for this manuscript. Institutional Review Board approval was obtained. Written informed consent was not required for this study because it is a retrospective study in which patient imaging was analysed. Some study subjects or cohorts have been previously reported in Winiowski et al., Journal of Vascular Surgery, 2011; ‘Predictors of outcome after elective endovascular abdominal aortic aneurysm repair and external validation of a risk prediction model’. Methodology: Retrospective, observational, multicenter study.

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Authors and Affiliations

  1. Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia, 4811

    Divyajeet Rai, Brendan Wisniowski, Barbara Bradshaw, Ramesh Velu, Patrik Tosenovsky, Francis Quigley, Philip J. Walker & Jonathan Golledge

  2. Department of Vascular and Endovascular Surgery, The Townsville Hospital, Douglas, Australia, 4811

    Divyajeet Rai, Ramesh Velu, Patrik Tosenovsky, Francis Quigley & Jonathan Golledge

  3. School of Medicine and Centre for Clinical Research, Department of Vascular Surgery, Royal Brisbane and Women’s Hospital, University of Queensland, Herston, QLD, Australia, 4006

    Brendan Wisniowski, Philip J. Walker & Jonathan Golledge

Authors
  1. Divyajeet Rai
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Correspondence to Jonathan Golledge.

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Rai, D., Wisniowski, B., Bradshaw, B. et al. Abdominal aortic aneurysm calcification and thrombus volume are not associated with outcome following endovascular abdominal aortic aneurysm repair. Eur Radiol 24, 1768–1776 (2014). https://doi.org/10.1007/s00330-014-3185-y

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  • DOI: https://doi.org/10.1007/s00330-014-3185-y

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