K van Rijn, O S van Genderen, H Putter, J P Eiberg, R C van Wissen, J F Hamming, J van Schaik, J R van der Vorst
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引用次数: 0
Abstract
Objectives: Elastic deformation (ED) is a novel non-invasive follow-up modality after endovascular aortic repair (EVAR). ED is defined as the percentage of diameter change of the aneurysm sac after application of a controlled ultrasound transducer pressure. It is hypothesized that low aneurysm sac deformation indicates high sac pressure. The current study aims to determine the ideal cut-off value of ED and analyze the corresponding diagnostic accuracy.
Methods: A prospective cohort study was performed at a single-center tertiary university hospital. ED measurements were performed during regular follow-up in all patients after endovascular aortic repair between August 2020 and December 2024. The reference test was subsequent aneurysm sac growth. Generalized estimating equations evaluated the association between ED and aneurysm sac growth. Receiver operating characteristic curve was used to assess the discriminatory ability.
Results: 203 ED measurements (in 100 post-EVAR patients) were analyzed. Aneurysm growth occurred in 12 patients. An odds ratio of 0.857 (95% CI 0.772-0.952) for aneurysm sac growth was calculated. ROC curve analysis revealed an AUC of 0.711 (95%CI 0.587-0.836, p=0.014). Optimal cut-off value according to the highest Youden index was estimated at 10.5% (sensitivity 92%, specificity 45%). A lower cut-off value of 6.5% also had significant discriminatory ability and was associated with higher specificity (sensitivity 58%, specificity 74%).
Conclusions: An ultrasound-based elastic deformation of 6.5% provides a straightforward and non-invasive method to predict post-EVAR aneurysm sac growth with high specificity. Further validation, including reproducibility testing between patients and operators, is needed before clinical implementation.
期刊介绍：
Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal:
Clinical Research (reports of clinical series, new drug or medical device trials)
Basic Science Research (new investigations, experimental work)
Case Reports (reports on a limited series of patients)
General Reviews (scholarly review of the existing literature on a relevant topic)
Developments in Endovascular and Endoscopic Surgery
Selected Techniques (technical maneuvers)
Historical Notes (interesting vignettes from the early days of vascular surgery)
Editorials/Correspondence
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