Is there a Relationship Between Endoleak and Antiaggregant Treatments in the Change of the Aneurysm Sac After Endovascular Treatment in Abdominal Aortic Aneurysm?

Abstract

Aim: It was aimed to determine the prognosis and treatment in relation to the risk factors of the patient group by recording the changes in aneurysm sac, thrombus diameter and thrombus load in the follow-up of patients treated with endovascular stent-graft for abdominal aortic aneurysm (AAA). Material and Methods: Preoperative and postoperative 1st, 3rd, 6th and 12th month CT-A's of 112 patients who were followed up regularly were performed and changes in aneurysm sac diameter, thrombus diameter and thrombus percentage were recorded. Results: When the measurements were evaluated, an increase was detected in the mean thrombus diameter at post-operative month 1 with a gradual reduction over time; however, it was observed to be higher than the pre-operative values even at month 12. These changes were statistically significant (p<0.001). Aneurysm sac diameters of the cases in the pre-operative work-up ranged between 50mm and 108mm with a mean of 65.53±12.08mm. Pre-operative thrombus burden was measured to be 28% minimum and 96% maximum with a mean of 61.8±18.69%. In the post-operative measurements, the mean thrombus burden was 86.0±13.47 at month 1, 85.9±15.46 at month 3, 82.94±14.27 at month 6 and 82.27±13.82 at month 12. Similar to the changes in thrombus diameter, there was an increase at month 1 with a gradual reduction over time; however, the values at month 12 were still higher than the pre-operative values. These changes were also statistically significant (p<0.001). Conclusion: The present study showed that the changes in aneurysm sac diameter and endoleak formation may affect prognosis and single antiaggregant treatment would be more suitable compared to the combination treatment.