Back to 2016 Annual Meeting Posters

OBJECTIVE: Thoracic endovascular aortic repair (TEVAR) has been a standard therapy for thoracic aortic aneurysm. However, post-operative endoleak occurs frequently, and it affects the long-term outcome. Although, trans-esophageal echocardiography (TEE) is known as a useful modality during TEVAR, there is no report describing the quantitative evaluation of endoleak by TEE. In this study, we hypothesized that the high-velocity flow (HVF) measured by TEE in the aneurysmal sac is associated with post-operative endoleak.
METHODS: Consecutive 246 patients who underwent TEVAR between December 2009 and August 2015 were reviewed. In these patients, 56 patients were evaluated intra-operatively by TEE from July 2014. These patients were divided into two groups, (i) group nEL consisted of patients with no endoleak by angiography (N=46), and (ii) group EL with endoleak by angiography (N=10). HVF was measured by TEE. Postoperative remaining endoleak was detected by computed tomography scan. To determine the cutoff point of HVF, receiver-operating characteristic (ROC) was analyzed with HVF and post-operative endoleak.
RESULTS: There were no significant differences between the preoperative characteristics of two groups, except sex (group EL VS group nEL, 80% VS 76%, P=0.02). In the group EL, endoleak type 1, 2, 3, and 4 were detected in 3, 1, 4, and 2 patients respectively. Cutoff point of HVF was calculated to 30.3 cm/s by ROC analysis (sensitivity 0.8, and specificity 0.45).
CONCLUSIONS: We evaluated endoleak quantitatively by using HVF with TEE. HVF is useful value to find out small endoleak, which was not detected by angiography. This value may give a meaningful information that endoleak should be treated or not.