Abstract
BACKGROUND: follow-up after endovascular abdominal aortic aneurysm
repair (EAR) generally consists of serial diameter measurements.
A size change after EAR, however, is the consequence of alterations
of the excluded aneurysm sac volume. OBJECTIVE: to assess the agreement
between diameter measurements and volume measurements after endovascular
aneurysm repair. PATIENTS AND METHODS: from 53 consecutive patients
scheduled for EAR, follow-up of at least 6 months was available in
35 patients. CTA was performed on all patients at discharge, at 6
months and yearly thereafter. The resulting 113 datasets were processed
on a workstation in a blinded and random order. Maximal aneurysm
diameter (DMAX) was measured along the central lumen line. Total
aneurysm volume was measured by manual segmentation. All measurements
of an individual patient were compared with each other, resulting
in 149 comparisons. The significance of individual size changes was
classified based on the 95\% confidence limits of the intra-observer
variability, using difference-of-means analysis. DMAX changes were
compared to volume changes. RESULTS: in 37\% of the comparisons,
discordance was found between DMAX and volume measurements. A decrease
in aneurysm size was missed using DMAX in 14\% of cases and an increase
in 19\% of cases. CONCLUSION: aneurysm size changes after EAR are
not noticed using maximal diameter measurements in over one-third
of cases.
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