Oversizing Consideration of Proximal Stent Graft in Hemodynamically Stable and Unstable Patients Undergoing Emergent Endovascular Aortic Repair
Consideration for oversizing the proximal stent graft is suggested in endovascular aortic repair. However, a special recommendation for the proximal oversizing ratio (OSR) in patients with ruptured abdominal aortic aneurysm (rAAA) is ambiguous. This study aims to evaluate the effect of different deg...
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| Format: | Article |
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MDPI AG
2023-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/23/7500 |
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| author | Yuhan Qi Chengxin Weng Ding Yuan Tiehao Wang Yukui Ma Yi Yang Jichun Zhao Bin Huang |
| author_facet | Yuhan Qi Chengxin Weng Ding Yuan Tiehao Wang Yukui Ma Yi Yang Jichun Zhao Bin Huang |
| author_sort | Yuhan Qi |
| collection | DOAJ |
| description | Consideration for oversizing the proximal stent graft is suggested in endovascular aortic repair. However, a special recommendation for the proximal oversizing ratio (OSR) in patients with ruptured abdominal aortic aneurysm (rAAA) is ambiguous. This study aims to evaluate the effect of different degrees of the proximal oversizing ratio (OSR) on risk of type IA endoleak (TIAEL) in hemodynamically stable and unstable patients with rAAA undergoing emergency endovascular aortic repair (EVAR). Our study included 134 rAAA patients undergoing emergent EVAR, and we did not observe a significant association between hemodynamic instability and risk of T1AEL (HR 3.89, 95%CI 0.40–37.75, <i>p</i> = 0.24). All three T1AELs in the hemodynamically unstable subgroup were observed in patients with OSR ≤ 30%, but no significant difference was found regarding T1AEL between patients with OSR > 30% and OSR ≤ 30% (0.00% vs. 11.11%, <i>p</i> = 0.19). As for hemodynamically stable patients, OSR > 20% was associated with a significantly decreased risk of T1AEL (HR 0.03, 95%CI 0.01–0.53, <i>p</i> = 0.016). In conclusion, a proximal OSR > 20% is associated with a decreased risk of T1AEL in hemodynamically stable patients, while an OSR > 30% did not add an additional advantage of lowering the risk of T1AEL in hemodynamically unstable patients. |
| first_indexed | 2024-03-09T01:47:51Z |
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| id | doaj.art-5e9c15f7b2194796a1145fbd4e500c8c |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T01:47:51Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-5e9c15f7b2194796a1145fbd4e500c8c2023-12-08T15:20:18ZengMDPI AGJournal of Clinical Medicine2077-03832023-12-011223750010.3390/jcm12237500Oversizing Consideration of Proximal Stent Graft in Hemodynamically Stable and Unstable Patients Undergoing Emergent Endovascular Aortic RepairYuhan Qi0Chengxin Weng1Ding Yuan2Tiehao Wang3Yukui Ma4Yi Yang5Jichun Zhao6Bin Huang7Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaDivision of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaDivision of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaDivision of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaDivision of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaDivision of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaDivision of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaDivision of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaConsideration for oversizing the proximal stent graft is suggested in endovascular aortic repair. However, a special recommendation for the proximal oversizing ratio (OSR) in patients with ruptured abdominal aortic aneurysm (rAAA) is ambiguous. This study aims to evaluate the effect of different degrees of the proximal oversizing ratio (OSR) on risk of type IA endoleak (TIAEL) in hemodynamically stable and unstable patients with rAAA undergoing emergency endovascular aortic repair (EVAR). Our study included 134 rAAA patients undergoing emergent EVAR, and we did not observe a significant association between hemodynamic instability and risk of T1AEL (HR 3.89, 95%CI 0.40–37.75, <i>p</i> = 0.24). All three T1AELs in the hemodynamically unstable subgroup were observed in patients with OSR ≤ 30%, but no significant difference was found regarding T1AEL between patients with OSR > 30% and OSR ≤ 30% (0.00% vs. 11.11%, <i>p</i> = 0.19). As for hemodynamically stable patients, OSR > 20% was associated with a significantly decreased risk of T1AEL (HR 0.03, 95%CI 0.01–0.53, <i>p</i> = 0.016). In conclusion, a proximal OSR > 20% is associated with a decreased risk of T1AEL in hemodynamically stable patients, while an OSR > 30% did not add an additional advantage of lowering the risk of T1AEL in hemodynamically unstable patients.https://www.mdpi.com/2077-0383/12/23/7500aortic aneurysmendovascular proceduresoversizing ratiotype IA endoleak |
| spellingShingle | Yuhan Qi Chengxin Weng Ding Yuan Tiehao Wang Yukui Ma Yi Yang Jichun Zhao Bin Huang Oversizing Consideration of Proximal Stent Graft in Hemodynamically Stable and Unstable Patients Undergoing Emergent Endovascular Aortic Repair Journal of Clinical Medicine aortic aneurysm endovascular procedures oversizing ratio type IA endoleak |
| title | Oversizing Consideration of Proximal Stent Graft in Hemodynamically Stable and Unstable Patients Undergoing Emergent Endovascular Aortic Repair |
| title_full | Oversizing Consideration of Proximal Stent Graft in Hemodynamically Stable and Unstable Patients Undergoing Emergent Endovascular Aortic Repair |
| title_fullStr | Oversizing Consideration of Proximal Stent Graft in Hemodynamically Stable and Unstable Patients Undergoing Emergent Endovascular Aortic Repair |
| title_full_unstemmed | Oversizing Consideration of Proximal Stent Graft in Hemodynamically Stable and Unstable Patients Undergoing Emergent Endovascular Aortic Repair |
| title_short | Oversizing Consideration of Proximal Stent Graft in Hemodynamically Stable and Unstable Patients Undergoing Emergent Endovascular Aortic Repair |
| title_sort | oversizing consideration of proximal stent graft in hemodynamically stable and unstable patients undergoing emergent endovascular aortic repair |
| topic | aortic aneurysm endovascular procedures oversizing ratio type IA endoleak |
| url | https://www.mdpi.com/2077-0383/12/23/7500 |
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