Effect of endoprostheses on pulse wave velocity and its long-term outcomes after thoracic endovascular aortic repair
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ORIGINAL ARTICLE
Effect of endoprostheses on pulse wave velocity and its long‑term outcomes after thoracic endovascular aortic repair Daijiro Hori1 · Koichi Yuri1 · Sho Kusadokoro1 · Toshikazu Shimizu1 · Naoyuki Kimura1 · Atsushi Yamaguchi1 Received: 11 January 2020 / Accepted: 15 March 2020 © The Japanese Association for Thoracic Surgery 2020
Abstract Background The purpose of this study was to evaluate the changes in pulse wave velocity and left ventricular dimensions in patients undergoing stent-graft treatment for aortic arch aneurysm. Methods From July 2008 to February 2019, 86 patients underwent thoracic endovascular aortic repair of an aortic arch aneurysm. Changes in pulse wave velocity (PWV), echocardiogram findings, and long-term outcomes were compared between endoskeleton type (n = 60) and exoskeleton type stent-graft (n = 26). Results There was no significant difference in patient demographics except for diabetes which was more observed in endoskeleton type (p = 0.017). There was a significant increase in PWV in exoskeleton type after surgery, which further progressed at a median follow-up of 32 months (before: 2047 cm/s vs. after: 2259 cm/s vs. follow-up: 2486 cm/s, p = 0.010, p = 0.017). No significant difference was observed in endoskeleton type (before: 1980 cm/s vs. after: 2058 cm/s, vs. followup: 2042 cm/s, p = 0.25, p = 0.34). Echocardiogram performed at a median period of 46.3 months, revealed a significant increase in left ventricular diastolic volume (LVDV) (before: 107.4 ± 20.6 ml vs. follow-up: 127.7 ± 27.5 ml, p = 0.003) and decrease in e′ (before: 5.5 ± 1.78 cm/s vs. follow-up: 4.7 ± 1.72 cm/s, p = 0.012) in exoskeleton type, while no significant change was observed in endoskeleton type (LVDV: before: 102.6 ± 32.3 ml vs. follow-up: 96.9 ± 35.4 ml, p = 0.74; e′: before: 4.4 ± 1.21 cm/s vs. follow-up: 4.8 ± 1.40 cm/s, p = 0.68). At the median period of 61.3 months, there was no significant difference in long-term mortality (p = 0.89). However, the endoskeleton type was associated with a lower incidence of a cardiac event (p = 0.034) and cerebrovascular event (p = 0.029). Conclusion Types of endoprosthesis might affect differently on physiological changes and its accommodated risk factors after surgery. Keywords Pulse wave velocity · Endoskeleton · Stent graft · Najuta · Aortic stiffness
Introduction With developments in endovascular therapy, there are many device options to treat a thoracic aortic aneurysm. Anatomical difficulty of the aortic arch has been challenged by different techniques including branching, debranching and
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11748-020-01343-0) contains supplementary material, which is available to authorized users. * Daijiro Hori [email protected] 1
Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, 1‑847, Amanuma‑cho, Omiya‑ku, Saitama, Saitama 330‑8503, Japan
fenestrations. Surgical success of these techniques has been reported with acc
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