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TY  - THES
AU  - Becker, Corinna
TI  - Infrarenal remains infrarenal - EVAR suitability of small AAA is rarely compromised despite morphological changes during surveillance
PB  - Rheinisch-Westfälische Technische Hochschule Aachen
VL  - Dissertation
CY  - Aachen
M1  - RWTH-2024-00059
SP  - 1 Online-Ressource : Illustrationen
PY  - 2023
N1  - Veröffentlicht auf dem Publikationsserver der RWTH Aachen University 2024
N1  - Dissertation, Rheinisch-Westfälische Technische Hochschule Aachen, 2023
AB  - Infrarenal Remains Infrarenal—EVAR Suitability of Small AAA Is Rarely Compromised despite Morphological Changes during Surveillance (Infrarenal bleibt infrarenal – Die Eignung für EVAR von kleinen AAA ist trotz morphologischer Veränderungen unter Surveillance nur selten beeinträchtigt)Introduction/Aim: The aim was to analyze the morphology of small abdominal aortic aneurysms (AAA) during surveillance, focusing mainly on aneurysm and aneurysm neck morphology with regard to suitability for endovascular aortic repair (EVAR).Methods: This retrospective single-center study included all patients with small asymptomatic AAA (≤5.4 cm) referred to our department between 2003 and 2018 and included in the surveillance program who underwent at least two computed tomography angiography (CTA) or magnetic resonance imaging (MRI) studies with a minimum interval of 6 months. Penetrating aortic ulcers (PAU), thoracoabdominal, post-dissection, anastomotic and infectious aneurysms as well as patients with ruptured AAA and those who underwent surgical therapy before the second CTA/MRI scan were excluded. Anatomical and morphological parameters including aneurysm diameter, neck shape, length and angulation, neck thrombus/calcification, aneurysm thrombus and diameter of distal landing zones were assessed on multiplanar reconstructions (MPR) and compared between the first and last CTA/MRI scans using descriptive statistics and correlation analysis. Possible changes in treatment strategies based on above-mentioned parameters were determined. AAA were classified as “with neck” (infra-/juxtarenal according to the European Society of Vascular Surgery (ESVS) definition) or “no neck” (suprarenal according to the ESVS definition). Results: 52 patients (48 male, 70±8 years at the time of first CTA/MRI scan) were included. There were 35 AAA with neck and 17 “no-neck” AAA. The aneurysm neck of most AAA with neck shortened at a mean rate of 2.0 ± 4.2 mm per year. Aneurysm neck thrombus was present in 31 patients in the first CTA/MRI; it remained constant in 6 cases, in 16 it increased, in 9 it decreased. One patient developed new neck thrombus over time. The average AAA diameter was 47.7 ± 9.3 mm at the time of the first and 56.3 ±11.6 mm at the time of the last CTA/MRI scan, the mean aneurysm growth rate was 4.2 mm/year. Aneurysm thrombus was present in 46 patients at the time of the first CTA/MRI; it increased in 32 patients, remained constant in 5 and decreased in 9 patients. 1 patient had new aneurysm thrombus formation in the last CTA/MRI There was a significant correlation between neck thrombus growth and the change of the neck length, between the amount of aneurysm thrombus and aneurysm growth as well as between aneurysm growth and change of the neck angulation. 46 (88
LB  - PUB:(DE-HGF)11
DO  - DOI:10.18154/RWTH-2024-00059
UR  - https://publications.rwth-aachen.de/record/976192
ER  -