Skip to main content

Advertisement

SpringerLink
Log in

Effect of endoskeleton stent graft design on pulse wave velocity in patients undergoing endovascular repair of the aortic arch

  • Original Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Purpose

Pulse wave velocity (PWV), which measures vascular stiffness, is a powerful predictor of cardiovascular event. Treatment of aneurysms with endovascular prosthesis has been reported to increase PWV. The purpose of this study was to evaluate whether an endoskeleton stent graft design has less effect on PWV than the exoskeleton stent graft design.

Methods

Between July 2008 and September 2016, 74 patients underwent endovascular treatment of aortic arch aneurysm in our institution. PWV before and after surgery were compared between those who underwent treatment with Najuta, an endoskeleton stent graft (n = 51), and those treated with other commercially available exoskeleton stent grafts (n = 23).

Results

Preoperative PWV (endoskeleton: 2004 ± 379.2 cm/s vs. exoskeleton: 2083 ± 454.5 cm/s, p = 0.47) was similar between the two groups. Factors that were associated with preoperative PWV were age (r = 0.37, 95% CI 0.15–0.56, p = 0.002) and mean arterial pressure (r = 0.53, 95% CI 0.34–0.68, p < 0.001). There was a significant increase in PWV in patients treated by exoskeleton stent grafts (before: 2083 ± 454.5 cm/s vs. after: 2305 ± 479.7 cm/s, p = 0.023) while endoskeleton stent graft showed no change in PWV (before: 2003 ± 379.2 vs. after: 2010 ± 521.1, p = 0.56). In a multivariate analysis, mean arterial pressure (coef 17.5, 95% CI 6.48–28.59, p = 0.002) and exoskeleton stent graft (coef 359.4, 95% CI 89.36–629.43, p = 0.010) were independently associated with PWV after surgery.

Conclusions

Physiological changes after endovascular treatment should be considered including effect on vascular stiffness. Endoskeleton stent graft may provide aneurysm repair with minimum effect in PWV after surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bengtsson H, Sonesson B, Bergqvist D. Incidence and prevalence of abdominal aortic aneurysms, estimated by necropsy studies and population screening by ultrasound. Ann N Y Acad Sci. 1996;800:1–24.

    Article  CAS  PubMed  Google Scholar 

  2. Zieman SJ, Melenovsky V, Kass DA. Mechanisms, pathophysiology, and therapy of arterial stiffness. Arterioscler Thromb Vasc Biol. 2005;25:932–43.

    Article  CAS  PubMed  Google Scholar 

  3. Fok H, Cruickshank JK. Future treatment of hypertension: shifting the focus from blood pressure lowering to arterial stiffness modulation? Curr Hypertens Rep. 2015;17:569.

    Article  Google Scholar 

  4. Guo X, Lu X, Yang J, Kassab GS. Increased aortic stiffness elevates pulse and mean pressure and compromises endothelial function in wistar rats. Am J Physiol Heart Circ Physiol. 2014;307:H880–7.

    Article  CAS  PubMed Central  Google Scholar 

  5. Reddy AK, Li YH, Pham TT, Ochoa LN, Trevino MT, Hartley CJ, et al. Measurement of aortic input impedance in mice: effects of age on aortic stiffness. Am J Physiol Heart Circ Physiol. 2003;285:H1464–70.

    Article  CAS  PubMed  Google Scholar 

  6. Wang YX, Halks-Miller M, Vergona R, Sullivan ME, Fitch R, Mallari C, et al. Increased aortic stiffness assessed by pulse wave velocity in apolipoprotein e-deficient mice. Am J Physiol Heart Circ Physiol. 2000;278:H428–34.

    CAS  PubMed  Google Scholar 

  7. Munakata M. Brachial-ankle pulse wave velocity: background, method, and clinical evidence. Pulse (Basel, Switzerland). 2016;3:195–204.

    Google Scholar 

  8. Yokoi Y, Azuma T, Yamazaki K. Advantage of a precurved fenestrated endograft for aortic arch disease: simplified arch aneurysm treatment in Japan 2010 and 2011. J Thorac Cardiovasc Surg. 2013;145:S103–9.

    Article  Google Scholar 

  9. Roy AK, Mc Gorrian C, Treacy C, Kavanaugh E, Brennan A, Mahon NG, et al. A comparison of traditional and novel definitions (rifle, akin, and kdigo) of acute kidney injury for the prediction of outcomes in acute decompensated heart failure. Cardioren Med. 2013;3:26–37.

    Article  Google Scholar 

  10. Funck KL, Laugesen E, Hoyem P, Fleischer J, Cichosz SL, Christiansen JS, et al. Low physical activity is associated with increased arterial stiffness in patients recently diagnosed with type 2 diabetes. Am J Hypertens. 2016;29(7):882–8.

    Article  PubMed  Google Scholar 

  11. Munakata M, Konno S, Miura Y, Yoshinaga K. Prognostic significance of the brachial-ankle pulse wave velocity in patients with essential hypertension: final results of the j-topp study. Hypertens Res. 2012;35:839–42.

    Article  CAS  Google Scholar 

  12. Palombo C, Kozakova M. Arterial stiffness, atherosclerosis and cardiovascular risk: pathophysiologic mechanisms and emerging clinical indications. Vasc Pharmacol. 2016;77:1–7.

    Article  CAS  Google Scholar 

  13. Janic M, Lunder M, Sabovic M. Arterial stiffness and cardiovascular therapy. Biomed Res Int. 2014;2014:621437.

    Article  PubMed Central  Google Scholar 

  14. Mirea O, Donoiu I, Plesea IE. Arterial aging: a brief review. Rom J Morphol Embryol. 2012;53:473–7.

    PubMed  Google Scholar 

  15. Polovina MM, Potpara TS. Endothelial dysfunction in metabolic and vascular disorders. Postgrad Med. 2014;126:38–53.

    Article  Google Scholar 

  16. Lantelme P, Dzudie A, Milon H, Bricca G, Legedz L, Chevalier JM, et al. Effect of abdominal aortic grafts on aortic stiffness and central hemodynamics. J Hypertens. 2009;27:1268–76.

    Article  CAS  Google Scholar 

  17. Morris L, Stefanov F, Hynes N, Diethrich EB, Sultan S. An experimental evaluation of device/arterial wall compliance mismatch for four stent-graft devices and a multi-layer flow modulator device for the treatment of abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2016;51:44–55.

    Article  CAS  Google Scholar 

  18. Moulakakis KG, Kadoglou NP, Antonopoulos CN, Mylonas SN, Kakisis J, Papadakis I, et al. Changes in arterial stiffness and n-terminal pro-brain natriuretic peptide levels after endovascular repair of descending thoracic aorta. Ann Vasc Surg. 2017;38:220–6.

    Article  Google Scholar 

  19. Kadoglou NP, Moulakakis KG, Papadakis I, Ikonomidis I, Alepaki M, Spathis A, et al. Differential effects of stent-graft fabrics on arterial stiffness in patients undergoing endovascular aneurysm repair. J Endovasc Ther. 2014;21:850–8.

    Article  Google Scholar 

  20. Takeda Y, Sakata Y, Ohtani T, Tamaki S, Omori Y, Tsukamoto Y, et al. Endovascular aortic repair increases vascular stiffness and alters cardiac structure and function. Circ J. 2014;78:322–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama, 330-8503, Japan

    Daijiro Hori, Kei Akiyoshi, Koichi Yuri, Satoshi Nishi, Takao Nonaka, Takahiro Yamamoto, Yusuke Imamura, Harunobu Matsumoto, Naoyuki Kimura & Atsushi Yamaguchi

Authors
  1. Daijiro Hori
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kei Akiyoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Koichi Yuri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Satoshi Nishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takao Nonaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takahiro Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yusuke Imamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Harunobu Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Naoyuki Kimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Atsushi Yamaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daijiro Hori.

Ethics declarations

Conflict of interest

The authors have declared that no conflict of interest exists.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hori, D., Akiyoshi, K., Yuri, K. et al. Effect of endoskeleton stent graft design on pulse wave velocity in patients undergoing endovascular repair of the aortic arch. Gen Thorac Cardiovasc Surg 65, 506–511 (2017). https://doi.org/10.1007/s11748-017-0787-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-017-0787-8

Keywords

Search

Navigation