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Mid-term clinical outcomes and morphological changes after endovascular aneurysm repair of inflammatory abdominal aortic aneurysms: a single-center experience

 Seung Hyun Lee  ;  Jong Yun Won  ;  Do Yun Lee  ;  Il Jung Kim  ;  Shin Jae Lee  ;  Man Deuk Kim  ;  Sung Il Park  ;  Kwang Hun Lee  ;  Young Guk Ko  ;  Dong-Hoon Choi  ;  Eun-Kyung Kim 
 ACTA RADIOLOGICA, Vol.56(3) : 304-311, 2015 
Journal Title
Issue Date
Aged ; Aortic Aneurysm, Abdominal/diagnostic imaging* ; Aortic Aneurysm, Abdominal/therapy* ; Blood Vessel Prosthesis* ; Contrast Media ; Endoleak/diagnostic imaging* ; Endoleak/therapy ; Endovascular Procedures/methods* ; Follow-Up Studies ; Humans ; Iopamidol ; Male ; Middle Aged ; Radiographic Image Enhancement/methods ; Radiographic Image Interpretation, Computer-Assisted/methods ; Retrospective Studies ; Stents ; Tomography, X-Ray Computed/methods ; Treatment Outcome
Abdominal aortic aneurysm ; CT ; endovascular procedures ; inflammatory perianeurysmal fibrosis ; stents ; treatment outcome
BACKGROUND: Endovascular aneurysm repair (EVAR) has been suggested as treatment for inflammatory abdominal aortic aneurysms (IAAA), but the actual clinical and radiological outcomes need to be evaluated.

PURPOSE: To report morphological changes in EVAR of IAAAs.

MATERIAL AND METHODS: Ten male patients (mean age, 67 years; range, 54-78 years) with IAAA were treated with EVAR using endovascular stent-grafts between March 2001 and January 2012. We retrospectively compared computed tomography angiography (CTA) images taken immediately (30 days after the EVAR), short-term (up to 1 year), and mid-term (beyond 1 year) to CTA images taken before the EVAR. Clinical success was defined as successful deployment of the stent-graft without a type I or III endoleak. Morphologic responses of IAAA to EVAR were reviewed by measuring the changes in aneurysm sac maximum diameter (mm), periaortic fibrosis (PAF) thickness (mm), and PAF enhancement (Hounsfield units [HU] on delayed CTA) on serial images.

RESULTS: Ten IAAA patients treated with EVAR were followed for a mean of 42 months (range, 7-129 months). No aneurysm-related deaths were observed during the follow-up of 10 patients. Primary clinical success was achieved in seven patients, assisted primary clinical success in one patient, and secondary clinical success in two patients. Aneurysm sac maximum diameter decreased in all patients (mean percentage reduction of 7.6%, 8.5%, and 17.3% in immediate, short-term, and mid-term follow-up CTA, respectively). PAF thickness decreased in eight patients (10.4%, 16.8%, and 27.2% regression upon follow-up). PAF enhancement decreased in nine patients and increased in one patient (mean percentage decrease of 13.0%, 27.3%, and 40.8% upon follow-up).

CONCLUSION: Treatment of IAAA with EVAR was effective and reduced aneurysmal sac diameter and the extent of PAF with acceptable morbidity.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Kim, In Joong(김인중)
Park, Sung Il(박성일)
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Kwang Hun(이광훈)
Lee, Do Yun(이도연)
Lee, Seung Hyun(이승현)
Lee, Shin Jae(이신재)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
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