Gender Differences in Aortic Neck Morphology in Patients with Abdominal Aortic Aneurysms Undergoing Elective Endovascular Aneurysm Repair
| Autor: | Thomas S. Maldonado, Caron B. Rockman, Sheila Blumberg, Andrew R. Baxter, Firas F. Mussa, Diego Ayo, Byron Gaing |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Radiography 030204 cardiovascular system & hematology Endovascular aneurysm repair 03 medical and health sciences Aortic aneurysm Sex Factors 0302 clinical medicine Risk Factors medicine Humans 030212 general & internal medicine Thrombus Aged Retrospective Studies Aged 80 and over business.industry Patient Selection Endovascular Procedures Thrombosis Retrospective cohort study General Medicine Middle Aged medicine.disease Abdominal aortic aneurysm Surgery Treatment Outcome Elective Surgical Procedures Female Radiology Cardiology and Cardiovascular Medicine Elective Surgical Procedure business Aortic Aneurysm Abdominal Abdominal surgery |
| Zdroj: | Annals of Vascular Surgery. 30:100-104 |
| ISSN: | 0890-5096 |
| DOI: | 10.1016/j.avsg.2015.09.002 |
| Popis: | Previous studies have demonstrated that women tend to have adverse aortic neck morphology leading to exclusion of some women from undergoing endovascular aneurysm repair (EVAR). The objective of this study is to investigate differences in aortic neck morphology in men versus women, changes in the neck morphology and sac behavior after EVAR, and investigate how these features may influence outcomes.We conducted a retrospective review of elective EVARs (2004-2013). We excluded patients who underwent elective EVAR with no postoperative imaging available and those patients with fenestrated repairs. Using TeraRecon and volumetric analysis, several features were investigated. These included percent thrombus, shape, length, angulation of the neck, and changes in neck and abdominal aortic aneurysm diameter.A total of 146 patients were found to meet inclusion criteria (115 men and 31 women) with similar baseline characteristics. Neck angulation was greater in women (23.9° vs. 13.5°; P0.028). The percent thrombus in women was higher than men (35.4% vs. 31%; P0.02). Abdominal aneurysm's were smaller in women at 1 year (4.2 cm vs. 5.1 cm; P0.002), and secondary interventions were higher in men (11.3% vs. 0%; P0.05). Other features such as neck shape, changes in neck diameter, neck length, and percent oversizing of graft where not statistically different between genders.Gender differences in neck characteristics and changes in neck morphology do not appear to adversely affect EVAR outcomes. Longer follow-up is necessary to further assess whether these findings are clinically durable. |
| Databáze: | OpenAIRE |
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