Aneurysm Sac Pressure during Branched Endovascular Aneurysm Repair versus Multilayer Flow Modulator Implantation in Patients with Thoracoabdominal Aortic Aneurysm

Maciej Antkiewicz; Wiktor Kuliczkowski; Marcin Protasiewicz; Tomasz Zubilewicz; Piotr Terlecki; Magdalena Kobielarz; Dariusz Janczak

doi:10.3390/ijerph192114563

Aneurysm Sac Pressure during Branched Endovascular Aneurysm Repair versus Multilayer Flow Modulator Implantation in Patients with Thoracoabdominal Aortic Aneurysm

Int J Environ Res Public Health. 2022 Nov 6;19(21):14563. doi: 10.3390/ijerph192114563.

Authors

Maciej Antkiewicz¹, Wiktor Kuliczkowski², Marcin Protasiewicz², Tomasz Zubilewicz³, Piotr Terlecki³, Magdalena Kobielarz⁴, Dariusz Janczak¹

Affiliations

¹ Department of Vascular, General and Transplantation Surgery, Wroclaw Medical University, 50-367 Wroclaw, Poland.
² Department of Cardiology, Wroclaw Medical University, 50-367 Wroclaw, Poland.
³ Department of Vascular Surgery and Angiology, Medical University of Lublin, 20-059 Lublin, Poland.
⁴ Department of Mechanics, Materials Science and Biomedical Engineering, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland.

Abstract

Open thoracoabdominal repair is the gold standard in the TAAA treatment. However, there are endovascular techniques, that sometimes may be an alternative, such as branched endovascular aneurysm repair (BEVAR) or implantation of the multilayer flow modulator (MFM). In this study, we aimed to assess differences in the aneurysm sac pressure (ASP) between patients undergoing BEVAR and MFM implantation. The study included 22 patients with TAAA (14 patients underwent BEVAR, while eight MFM implantation). The pressure sensor wire was placed inside the aneurysm. A measurement of ASP and aortic pressure (AP) was performed during the procedure. The systolic pressure index (SPI), diastolic pressure index (DPI), and pulse pressure index (PPI) were calculated as a quotient of the ASP and AP values. After the procedure, SPI and PPI were lower in the BEVAR group than in the MFM group. During a procedure, a drop in SPI and PPI was noted in patients undergoing BEVAR, while no changes were revealed in the MFM group. This indicates that BEVAR, but not MFM, is associated with a reduction in systolic and pulse pressure in the aneurysm sac in patients with TAAA.

Keywords: aneurysm sac pressure; endovascular aneurysm repair; multilayer flow modulator; thoracoabdominal aneurysm.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aortic Aneurysm, Abdominal* / surgery
Aortic Aneurysm, Thoracic* / surgery
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation*
Endovascular Procedures* / methods
Humans
Prosthesis Design
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome

Grants and funding

This research was funded by the Ministry of Health subventions according to number of SUB.C020.21.078 from the IT Simple system of Wroclaw Medical University.