Retrospective Analysis of Calcification of Abdominal Aortic Aneurysm (AAA) as a Predictor of Type 2 Endoleak in Endovascular Aortic Aneurysm Repair (EVAR)

LL-VI4264-R08

Retrospective Analysis of Calcification of Abdominal Aortic Aneurysm (AAA) as a Predictor of Type 2 Endoleak in Endovascular Aortic Aneurysm Repair (EVAR)

Scientific Posters

Presented on December 4, 2008
Presented as part of LL-VI-R: Vascular/Interventional

Kavulani Lucy Mutiso MBBCh, MRCP, Presenter: Nothing to Disclose

Iheoma Amaechi MBBS, Abstract Co-Author: Nothing to Disclose

David Evans MD, Abstract Co-Author: Nothing to Disclose

Keith Jones MBChB, Abstract Co-Author: Nothing to Disclose

To determine whether the volume of AAA calcification is a useful pre-operative prognostic indicator in patients undergoing EVAR.

Database of patients who have undergone EVARs between 2005 and 2007 at Kings College Hospital, London. The pre-op CT thin slices(1-2mm) were used to quantify the volume of calcification within the aneurysm. The 64 slice GE workstation Autobone Express programme volume calculator was used to calculate the volume of calcification (cm3). The volumes obtained for each patient were then correlated with the results of the 24hr and 6 week post operative assessment of endoleaks with either CT or Duplex ultrasound.

A total of 45 patients were included in the study. 15/45 (33.3%) had < 1cm3 of AAA calcification; 4/15 (26.7%) had type 2 endoleaks within 24hrs, 2/15 (13.3%) had type 2 at the 6 week review. 11/45 (24.4%) had 1-2 cm3 AAA calcification; 2/11 (18.2%) had type 2 endoleaks at 24 hrs; none had endoleaks at the 6 week review. 12/45 (26.7%) had 2-4 cm3 AAA calcification 4/12 (33.3%) had type 2 leak at 24hrs and at 6 weeks review. 6/45 (13.3 %) had >4cm3 AAA calcification; 3/6 (50%) had type 2 endloeak at 24hrs, 2/6 (33.3%) had type 2 endoleaks at 6 weeks.

All cases of endoleaks were type 2. The results demonstrated an increasing frequency of endoleaks with increasing volume of calcification at 24hrs and 6 weeks post-operative. This suggests that the pre-operative quantification of calcification may prove to be a valuable indicator of post-operative outcome in EVAR.

The volume of abdominal aortic aneurysm calcification may need to be considered during the pre-procedural assessment in determining patient suitability for undergoing EVAR.

Mutiso, K, Amaechi, I, Evans, D, Jones, K, Retrospective Analysis of Calcification of Abdominal Aortic Aneurysm (AAA) as a Predictor of Type 2 Endoleak in Endovascular Aortic Aneurysm Repair (EVAR). Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6017433.html