Pulsatile wall motion (PWM) measurements after endovascular abdominal aortic aneurysm exclusion are not useful in the classification of endoleak.

Abstract

The pulsatile wall motion (PWM) of AAA is reduced after endovascular stent-graft placement. The purpose of this study was to identify whether PWM after endografting was useful in the classification of endoleak. 162 patients treated with EVAR underwent pre- and post-operative PWM assessment with ultrasonography. Follow-up was 1-9 years. 111 patients had well-excluded aneurysms, three patients had enlarging aneurysms without any recognizable endoleak (endotension), 16 had type I, 31 had type II and 1 had type III endoleak. The PWM was reduced from about 1mm pre-operatively to 0.24 mm post-operatively in well-excluded aneurysms. PWM remained stable during follow-up. Type I endoleak was associated with moderately reduced PWM (proximal endoleak 0.79 mm and distal 0.32 mm). PWM in patients with type II endoleak was higher (0.32 mm) post-operatively (p=0.002) compared to well-excluded aneurysms. PWM is permanently reduced after endografting. The smallest reduction in PWM was in patients with type II endoleaks. However, the overlap between the groups does not allow reliable identification of patients having endoleak with PWM-measurements.