RESEARCH ARTICLE


Evaluation of Aortic Stiffness (Aortic Pulse–Wave Velocity) Before and After Elective Abdominal Aortic Aneurysm Repair Procedures: A Pilot Study#



Kosmas I Paraskevas1, *, Nikolaos Bessias1, Chrysovalantis Psathas2, Konstantinos Akridas2, Theodoros Dragios2, Georgios Nikitas2, Vassilios Andrikopoulos1, Dimitri P Mikhailidis3, Zenon S Kyriakides2
1 Department of Vascular Surgery, Red Cross Hospital, Athens, Greece
2 Department of Cardiology, Red Cross Hospital, Athens, Greece
3 Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, UK


© Paraskevas et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Vascular Surgery, Red Cross Hospital, 24 Al. Papagou street, Athens 14122, Greece, E-mail: paraskevask@hotmail.com


Abstract

Background:

The main clinical criterion for abdominal aortic aneurysm (AAA) repair operations is an AAA diameter ≥5.5 cm. When AAAs increase in size, specific changes occur in the mechanical properties of the aortic wall. Pulse-wave velocity (PWV) has been used as an indicator of vascular stiffness. A low PWV may predict AAA rupture risk and is an early predictor of cardiovascular mortality.

Methods:

We investigated the prognostic value of PWV before and after elective AAA repair procedures. Twenty four patients scheduled for an open AAA repair underwent a preoperative carotid-femoral aortic PWV measurement. A second aortic PWV measurement was carried out 6 months postoperatively.

Results:

The mean aortic PWV increased from 7.84 ± 1.85 preoperatively to 10.08 ± 1.57 m/sec 6 months postoperatively (mean change: 2.25; 95% confidence interval 1.4 to 3.1 m/sec; p<0.0001). The preprocedural PWV measurement did not correlate with AAA diameter (Spearman’s rank correlation coefficient ρ=0.12; p=0.59).

Conclusions:

Whether the increase in aortic PWV postoperatively suggests a decreased cardiovascular risk following AAA repair remains to be established. Aortic PWV should also be investigated as an adjunct tool for assessing AAA rupture risk.

Keywords: Abdominal aortic aneurysm, pulse-wave velocity, aneurysm rupture risk, cardiovascular mortality, predictor..