Efficacy of volumetric analysis of aorta as surveillance tool after EVAR

Objective: Compared to the diameter measurement, volume measurement of the aneurysm can be an alternative option for accurate evaluation. This study was undertaken to analyze the relationship between the diameter and the volume measurement of the aorta after EVAR. Methods: From January 2012 to December 2016, 82 patients underwent EVAR in our institution. The infrarenal aorta after EVAR was evaluated with regard to maximal aortic diameter (DMAX) and aortic volume. The relationship between the DMAX and the aortic volume measurement after EVAR were analyzed. Results: The rate of enlargement of aortic volume with endoleak over time was 0.02 cm³/month. The rate of enlargement of DMAX with endoleak over time was 0.007 mm/month. The mean rate of enlargement of aortic volume was significantly different from the mean enlargement rate of DMAX (p = 0.02). A ≥12% of increase rate of aortic volume was equivalent to an increase of ≥5 mm in the DMAX after EVAR. Significantly more endoleak occurred in the DMAX-enlargement group than no-enlargement group (100% vs. 26.76%, p < 0.001). Significantly more patients need secondary intervention and treatment of endoleak in the DMAX-enlargement group (p = 0.02 and p < 0.001, respectively). Significantly more endoleak occurred in the aortic volume–enlargement group than no-enlargement group (90.91% vs. 16.67%, p < 0.001). Significantly more patients needed secondary intervention and treatment for endoleak in the aortic volume–enlargement group (p = 0.02 and p < 0.001, respectively). Conclusion: Volumetric analysis can predict successful EVAR more accurate than diameter measurement. A ≥12% increase in aortic volume was equivalent to a ≥5 mm increase in aortic diameter.