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Systolic Sac Pressure Index for the Prediction of Persistent Type II Endoleak for 12 Months After Endovascular Abdominal Aortic Aneurysm Repair

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Abstract

Purpose

To assess the relationship between the systolic sac pressure index (SPI) and the presence of endoleaks 12 months after endovascular abdominal aortic aneurysm repair (EVAR).

Materials and Methods

We performed a single-center prospective trial of consecutively treated patients. SPI (calculated as systolic sac pressure/systolic aortic pressure) was measured by catheterization immediately after EVAR. Contrast-enhanced computed tomography was scheduled 12 months after EVAR to detect possible endoleaks.

Results

Data were available for 34 patients who underwent EVAR for an AAA. Persisting type II endoleak was found in 8 patients (endoleak-positive group) but not in the other 26 patients (endoleak-negative group). The mean ± standard deviation SPI was significantly greater in the endoleak-positive group than in the endoleak-negative group (0.692 ± 0.048 vs. 0.505 ± 0.081, respectively; P = .001). Receiver-operating characteristic curve analysis revealed that an SPI of 0.638 was the optimum cutoff value for predicting a persistent endoleak at 12 months with high accuracy (0.971; 33/34), sensitivity (1.00), and specificity (0.962) values. The mean change in AAA diameter was −4.28 ± 5.03 mm and 2.22 ± 4.54 mm in patients with SPI of <0.638 or ≥0.638, respectively (P = .002).

Conclusion

Patients with an SPI of ≥0.638 immediately after EVAR were more likely to have a persistent type II endoleak at 12 months with an accuracy of 0.971, and showed increases in aneurysm sac diameter compared with patients with an SPI of <0.638.

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Abbreviations

AAA:

Abdominal aortic aneurysm

CT:

Computed tomography

EVAR:

Endovascular abdominal aortic repair

ROC:

Receiver-operating characteristic

SD:

Standard deviation

SPI:

Sac pressure index (systolic sac pressure/systolic aortic pressure)

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Authors and Affiliations

  1. Departments of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama-shi, Wakayama, 641-8510, Japan

    Akira Ikoma, Motoki Nakai, Morio Sato, Hirotatsu Sato, Hiroki Minamiguchi & Tetsuo Sonomura

  2. Thoracic and Cardiovascular Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama-shi, Wakayama, 641-8510, Japan

    Yoshiharu Nishimura & Yoshitaka Okamura

Authors
  1. Akira Ikoma
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  2. Motoki Nakai
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  3. Morio Sato
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  4. Hirotatsu Sato
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  5. Hiroki Minamiguchi
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  6. Tetsuo Sonomura
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  7. Yoshiharu Nishimura
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  8. Yoshitaka Okamura
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Corresponding author

Correspondence to Morio Sato.

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Conflict of Interest

All authors have no conflicts of interest to declare. The authors have no personal financial or institutional interest in any of the drugs, materials, or devices documented in this manuscript.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human and Animal Rights

The study was approved by our institutional ethics committee and performed in accordance with the ethical standards as laid down in the1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Ikoma, A., Nakai, M., Sato, M. et al. Systolic Sac Pressure Index for the Prediction of Persistent Type II Endoleak for 12 Months After Endovascular Abdominal Aortic Aneurysm Repair. Cardiovasc Intervent Radiol 39, 522–529 (2016). https://doi.org/10.1007/s00270-015-1191-3

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  • DOI: https://doi.org/10.1007/s00270-015-1191-3

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