The Clinical Significance Of The Morphology Of The Proximal Neck And Aneurysm In Perioperative Period Of Endovascular Aneurysm Repair

Objective: Through the reconstruction and measurement the imaging data of the patients after endovascular abdominal aortic aneurysm repair, and evaluating the correlation among the related indicators of the proximal neck and aneurysm and the influence on clinical effect, analyzing the significance of the morphology of the proximal neck and aneurysm in perioperative period of EVAR.Methods: The CTA imaging data before EVAR and the clinical data in perioperative period of the AAA patients from January 2009 to September 2014 were collected, then the CTA imaging data were reconstructed and the related indicators of the proximal neck and aneurysm were measured through the Osirix software, the correlation among the related indicators and the influence on clinical effect after EVAR of the proximal neck and aneurysm were analyzed.Results: The diameters between the superior border and inferior border of the proximal neck were moderately positive correlated(r=0.744, P<0.001), the diameters of the lumen and the aneurysm were moderately positive correlated(r=0.666, P<0.001), the diameter and the length of the aneurysm were moderately positive correlated(r=0.594, P<0.001), the diameter of the proximal neck and the length of the aneurysm were low positive correlated, the lengths of the proximal neck and the length of the aneurysm were moderately negative correlation(r=-0.545, P<0.001), and there were no no obvious correlation between the length of the proximal neck and the diameter of the aneurysm(r=-0.120, P=0.208). The length, infrarenal angle of the proximal neck, the diameter and length of the aneurysm had an influence on the occurrence of the proximal type I endoleak.Conclusion: The larger the diameter of the superior border of the proximal neck is, the larger the diameter of the inferior border of the proximal neck is. The diameter of the aneurysm has an obvious effect on other indicators of the proximal neck and aneurysm. The larger the diameter of aneurysm is,the larger the diameter of the proximal neck is, and so are the diameter of the lumen and the length of the aneurysm, but there are no no obvious correlation between the diameter of the aneurysm and the length of the proximal neck. The abnormity of the proximal neck and aneurysm is an an important factor of the occurence of the proximal type I endoleak. Accurate measurement and evaluation on the morphology of AAA before operation, discovery in time and positive repair intraoperative, are the key to the prevention and treatment of proximal type I endoleak.