P-056 Changes in Psoas Muscle Area and Lean Muscular Area after Elective Endovascular Aneurysm Repair
Year: 2021
Type: conference-abstract
Study design: Observational Study
Abstract: Introduction: Sarcopenia has assumed growing relevance as a morbidity/mortality predictor after major abdominal surgery.Previous studies have shown reduced survival in patients with low total psoas muscle area (TPA) and low lean muscular area (LMA) submitted to elective endovascular aneurysm repair (EVAR).Also, recent studies have shown that psoas muscle volume reduces after EVAR.The aim of this study was to access TPA, LMA, and muscle density (MD) changes after EVAR and evaluate associated risk factors.Methods: Asymptomatic patients submitted to aortic endoprosthesis implantation between 1 January 2014 and 31 December 2018 in our vascular surgery department were retrospectively evaluated.After exclusion criteria were applied, 74 patients were included and pre-EVAR and one year post-EVAR computed tomography (CT) scans were evaluated using OSIRIX software (Bernex, Switzerland).Two observers independently calculated TPA at the most caudal level of the L3 vertebra and respective density, therefore calculating LMA.Patient characteristics and intra-operative and postoperative period variables were collected.Charlson Comorbidity Index was calculated and surgical complications classified according to Clavien-Dindo.The variation in TPA, LMA, and MD between the pre-operative and postoperative periods was assessed and patients divided into groups and compared among themselves.Statistical analysis was performed using SPSS version 24 (IBM, Armonk, NY, USA).Results: The study cohort included 74 patients with a mean age of 72.73 years.The average size of the aneurysms was 6.31 cm and the average length of stay was 3.42 days.When comparing the pre-operative with the one year post-EVAR CT scans, an average decrease in both TPA (11.8%) and LMA (7.1%), as well as an increase in average MD (5.1%), was observed.Patients with an increase in TPA had higher pre-operative lactate dehydrogenase levels (p ¼ .049),higher mean aneurysm size (p ¼ .043),and lower contrast volume administered (p ¼ .052)during EVAR.Patients with an increase in LMA had both a higher incidence of previous coronary heart disease (p ¼ .057)and higher body mass index (p ¼ .043).In addition, it was also observed that MD variation, as a result of muscular steatosis, is influenced by dyslipidaemia (p ¼ .009).Conclusion: This study suggests that after EVAR both PMA and LMA are reduced and these changes seem to be related to patient and procedure variables rather than with EVAR itself.
Source: EJVES Vascular Forum
Authors: Vânia C. Oliveira, Mário Moreira, Bárbara Pereira, Mafalda Correia, Pedro Lima, Joana C. Silva, Ricardo V. Pereira, Manuel Fonseca
Institution: Unidade Local de Saúde de Coimbra
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,630
OpenAlex ID: W4205551007