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Document Type

Original Article

Abstract

Background: Early endovascular procedures were used to treat elderly patients with severe co-existing conditions who couldn't undergo open surgery. Aim of work: The study aimed to evaluate the IVUS's effectiveness in performing endovascular repair of abdominal aortic aneurysm and its involvement in chronic renal disease, as well as to compare the accuracy of aortic measurements performed with IVUS and intra-arterial contrast agent. Patients and Methods: Between December 2017 and December 2019, this prospective, randomized, single-blinded research was carried out at military hospitals and Al-Azhar University hospitals. It included twenty patients complaining of infrarenal abdominal aortic aneurysm. According to treatment policy, patients were randomly split into two groups: Group A: managed by EVAR with an intra-arterial contrast agent. Group B: treated by EVAR with intravascular ultrasound. Results: Based on ROC curve analysis, access artery diameter (right or left iliac) by IVUS can significantly predict the effect of EVAR in decreasing aneurysmal size (AUC= 0.88, P= 0.003). At cut-off>14 mm, access artery diameter gives a sensitivity of 100%, specificity of 80%, PPV of 83.3%, and NPV of 100%. There was a reasonable agreement between CT and IVUS in evaluating different aortic measurements. Conclusion: Based on our analysis, we concluded that IVUS is a valuable tool in assessing the aortic measures accurately when compared to CT; therefore, in the repair of abdominal aortic aneurysm.

Keywords

Intravascular Ultrasound (IVUS); Endovascular Aorto-iliac Aneurysm Repair; chronic kidney disease; CT angiography.

Subject Area

General Surgery

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