Year: 2025
Type: article
Abstract: Objective: Endovascular aneurysm repair (EVAR) constitutes the cornerstone of contemporary abdominal aortic aneurysm (AAA) treatment, owing to superior short-term outcomes in comparison with open surgical repair (OSR).However, this difference is offset by unfavorable long-term outcomes.EVAR may detrimentally affect aortic compliance, with significant subsequent consequences.We sought to elucidate the natural history of this phenomenon. Methods:We conducted a nonrandomized, prospective study of 140 consecutive patients undergoing elective EVAR or OSR for abdominal aortic aneurysm.Aortic stiffness was measured preoperatively (T0), within 1 week of the operation (T1), 4 to 6 weeks (T2), and at 1 year (T3), using a validated noninvasive device (Vicorder) to measure carotid-femoral pulse wave velocity (cfPWV) and brachial-femoral pulse wave velocity (bfPWV), as well as central pulse pressure.Repeated measures analysis of variance was applied to the hemodynamic measurements to quantify changes along time.Results: Of 140 patients, 130 (93%) underwent EVAR.EVAR resulted in a significant increase in carotid-femoral pulse wave velocity (T0, 9.9 ± 1.3 m/s; T1, 11.0 ± 1.6 m/s; T2, 12.2 ± 3.8 m/s; and T3, 12.5 ± 2.6 m/s; P < .05for the comparison with T0), bfPWV (T0, 34.6 ± 12 mm Hg; T1, 40.4 ± 12.4 mm Hg; T2, 44.2 ± 14.6 mm Hg; and T3, 44.3 ± 12.6 mm Hg; P < .05for the comparison with T0), and central pulse pressure (T0, 59 ± 12 mm Hg; T1, 61 ± 12 mm Hg; T2, 63 ± 13; and T3, 64 ± 12 mm Hg mm Hg; P < .05for the comparison of T2 and T3 with T0).There were no significant differences across all timepoints for those having OSR. Conclusions:In this study, the first to use bfPWV in this context, EVAR, but not OSR, significantly decreased aortic compliance, not only immediately post intervention, but steadily over 1 year.(JVS-Vascular Insights 2026;■:100344.
Source: JVS-Vascular Insights
Authors: Dimitrios Vlastos, Athanasios Saratzis, Stefan Klimach, Emily Salt, Arooj Siddique, John S.M. Houghton, Vimal Gokani, Alexia Minas, Ignatios Ikonomidis, Rob D. Sayers, Matthew J. Bown
Institutions: University of Leicester, National and Kapodistrian University of Athens, University Hospitals of Leicester NHS Trust, University General Hospital Attikon, NIHR Leicester Biomedical Research Centre, Nottingham University Hospitals NHS Trust, University Hospitals of Derby and Burton NHS Foundation Trust, Imperial College Healthcare NHS Trust, Charing Cross Hospital
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,000
Funder: British Heart Foundation
OpenAlex ID: W4417515986