O-203 - ELASTIC DEFORMATION: A RELIABLE, NON-INVASIVE, METHOD FOR THE EXCLUSION OF ENDOLEAK AFTER ENDOVASCULAR AORTIC ANEURYSM REPAIR

TOPIC:
Abdominal Aortic Aneurysms
AUTHORS:
Van Genderen O.S. (Leiden University Medical Center ~ Leiden ~ Netherlands) , Van Wissen R.C. (Leiden University Medical Center ~ Leiden ~ Netherlands) , Hamming J.F. (Leiden University Medical Center ~ Leiden ~ Netherlands) , Van Schaik J. (Leiden University Medical Center ~ Leiden ~ Netherlands) , Van Der Vorst J.R. (Leiden University Medical Center ~ Leiden ~ Netherlands)
Introduction:
Increasing evidence is being provided that aneurysm sac pressure after endovascular aortic repair (EVAR) can be used as a surrogate to determine whether a secondary intervention is warranted. Nevertheless, current guidelines are inconclusive regarding the most cost- and clinically effective surveillance protocol for the detection of high-aneurysm sac pressure and accompanying endoleak after EVAR. Elastic Deformation(ED%) is a non-invasive novel method, based on color duplex ultrasound (CDU), and can be used to evaluate endoleak after endovascular aortic repair (EVAR). If an aneurysm sac, which is completely excluded from the circulation, has a reduced sac pressure; making it more compressible, one can hypothesize that Elastic Deformation(ED%) can serve as a predictor to exclude endoleak( figure 1). We studied whether ED can be used to exclude endoleak post-EVAR procedure.
Methods:
A retrospective cohort study of patients monitored for untreated abdominal aortic aneurysms or during the follow up after EVAR between August, 2020, and September, 2021. Data was collected following our local protocol and patients were divided into three groups. Patients with abdominal aortic aneurysms (AAA group), patients after EVAR with endoleak (LEAK group), and patients after EVAR without endoleak (NO LEAK group).
Results:
A total of 109 patients (median (IQR) age: 68 (71-83) years; n=10 [10%] were female) were included. 24 patients in the AAA group, 26 in the LEAK group, and 59 in the NO LEAK group. The mean ED in the AAA group was 2.0% (SD+/-1.5), 3;3% (SD+/- 2,9) in the LEAK group, and 11,3% (SD+/-5,3) in the NO LEAK group. The diagnostic accuracy in excluding leakage was very reliable (area under the receiver operating characteristic curve = 0.91 (95% confidence interval (CI) = 0.85 to 0.97)) with a sensitivity of 0.64 and a specificity of 1.0. The optimal cutoff was 9.5% ED. A higher ED in the NO LEAK group is associated with absence of endoleak on contrast-enhanced computed tomography (CTA) (Spearman's p =0,368; p<0,001).
Conclusion:
High ED reliably excludes endoleak post-EVAR and is well associated with absence of endoleak on CTA.
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