TY - JOUR
T1 - Validation of Central Pressure Estimation in Patients with an Aortic Aneurysm Before and After Endovascular Repair
AU - Holewijn, S.
AU - Vermeulen, J. J.M.
AU - van Helvert, M.
AU - van de Velde, L.
AU - Reijnen, M. M.P.J.
N1 - Publisher Copyright:
© 2021, Biomedical Engineering Society.
PY - 2022/4
Y1 - 2022/4
N2 - Purpose: The aim of this study was to investigate if non-invasive central pressure estimations are accurate in patients with an abdominal aortic aneurysm, before and after endovascular repair. Secondary evaluation was if measurement-accuracy was dependent on anatomical characteristics. Methods: Procedural invasive and non-invasive pressure-measurements were performed simultaneously both before and after endovascular repair in 20 patients with an infrarenal abdominal aortic aneurysm. Invasive catheter measurements were performed in the abdominal aorta. A tonometric device was used to perform non-invasive pressure–wave-analysis at the radial artery. A generalized transfer-function was used to generate an ascending aortic waveform for both measurements, allowing for direct comparison. Results: Pre-treatment the mean differences between methods were − 5.5 mmHg (p = .904), − 11.8 (p < .001), and − 7.2 mmHg (p = .124) for central systolic, diastolic, and mean pressure, respectively. The accuracy was dependent of aneurysm sac volume and intraluminal thrombus volume. Post-treatment limits of agreement were smaller for all pressure parameters compared to pre-treatment. The mean differences were 6.5 mmHg (p = .007), − 6.4 (p < .020), and 1.6 mmHg (p = .370) for central systolic, diastolic, and mean pressure, respectively. Conclusion: In untreated AAA’s the accuracy of non-invasive central pressure estimation was acceptable (mean difference between 5 and 10 mmHg) when compared to invasive pressures, but dependent of AAA characteristics. After EVAR the accuracy of central pressure estimation improved (reduction of 75% of the mean difference between pre and post measurements) Trial Registration Number: NCT03469388; 3-5-2018.
AB - Purpose: The aim of this study was to investigate if non-invasive central pressure estimations are accurate in patients with an abdominal aortic aneurysm, before and after endovascular repair. Secondary evaluation was if measurement-accuracy was dependent on anatomical characteristics. Methods: Procedural invasive and non-invasive pressure-measurements were performed simultaneously both before and after endovascular repair in 20 patients with an infrarenal abdominal aortic aneurysm. Invasive catheter measurements were performed in the abdominal aorta. A tonometric device was used to perform non-invasive pressure–wave-analysis at the radial artery. A generalized transfer-function was used to generate an ascending aortic waveform for both measurements, allowing for direct comparison. Results: Pre-treatment the mean differences between methods were − 5.5 mmHg (p = .904), − 11.8 (p < .001), and − 7.2 mmHg (p = .124) for central systolic, diastolic, and mean pressure, respectively. The accuracy was dependent of aneurysm sac volume and intraluminal thrombus volume. Post-treatment limits of agreement were smaller for all pressure parameters compared to pre-treatment. The mean differences were 6.5 mmHg (p = .007), − 6.4 (p < .020), and 1.6 mmHg (p = .370) for central systolic, diastolic, and mean pressure, respectively. Conclusion: In untreated AAA’s the accuracy of non-invasive central pressure estimation was acceptable (mean difference between 5 and 10 mmHg) when compared to invasive pressures, but dependent of AAA characteristics. After EVAR the accuracy of central pressure estimation improved (reduction of 75% of the mean difference between pre and post measurements) Trial Registration Number: NCT03469388; 3-5-2018.
KW - Abdominal aortic aneurysm
KW - Augmentation index
KW - Central blood pressure
KW - Endovascular aneurysm repair
KW - Pressure wave analysis
KW - Subendocardial viability ratio
KW - UT-Hybrid-D
KW - 22/2 OA procedure
UR - http://www.scopus.com/inward/record.url?scp=85115840083&partnerID=8YFLogxK
U2 - 10.1007/s13239-021-00574-3
DO - 10.1007/s13239-021-00574-3
M3 - Article
AN - SCOPUS:85115840083
SN - 1869-408X
VL - 13
SP - 265
EP - 278
JO - Cardiovascular engineering and technology
JF - Cardiovascular engineering and technology
ER -