Changes in blood flow within visceral vessels and vessels of the pelvis in patients after stent graft implantation due to an abdominal aortic aneurysm
Journal Title: Postępy Nauk Medycznych - Year 2012, Vol 25, Issue 8
Abstract
<b>Introduction.</b> Surgery of aortic aneurysms and iliac artery aneurysms are associated with postoperative ischemic colitis and corresponding general mortality of 1-8%. Endovascular aneurysm treatment technique using stent graft did not prevent the occurrence of this complication. Using CDD ultrasound for the visceral arteries evaluation, we obtain information on condition of the celiac vascular bed, which allows determining the risk of this complication occurrence.<br><b>Material and methods. </b>A prospective study started in reference to Colour Duplex-Doppler (CDD) ultrasound evaluation of the visceral arteries in a group of 60 patients treated for AAA by a stent graft compared to a control group of 78 patients undergoing long-term treatment due to AAA and Leriche syndrome treated with open surgery of aortobifemoral Y-graft implantation. In both groups, CDD ultrasound technique was used in order to evaluate morphological and functional aspect of the visceral arteries: CT, SMA, IMA, and the internal iliac arteries. Initially, 10 patients were examined. Standard parameters of blood flow were determined by Doppler method. Measurements were performed before and after a stent graft implantation. In order to determine the risk of ischemia previously developed so-called indicators of ischemia were used: velocity and resistance.<br><b>Results. </b>In the studied material, predictions with CDD ultrasound were made before surgery and these predictions were verified after a surgery, which resulted in clinical confirmation of three cases of mild pelvic ischemia in the form of intermittent claudication, and 1 case of ischemic colitis in the form of transient diarrhoea. The ultrasound risk factors for ischemia were described and the manner of establishing type of ischemia (occlusive/non-occlusive) was developed.
Authors and Affiliations
Paweł Dąbek, Włodzimierz Hendiger, Grzegorz Madycki, Walerian Staszkiewicz
Keywords
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