gms | German Medical Science

122. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

05. bis 08.04.2005, München

Intra-abdominal pressure influences the aneurysm sac pressure following endovascular aneurysm exclusion : experimental findings

Meeting Abstract

  • corresponding author M. Gawenda - Schwerpunkt Gefäßchirurgie, Klinikum der Universität zu Köln
  • St. Winter - Schwerpunkt Gefäßchirurgie, Klinikum der Universität zu Köln
  • G. Jaschke - Schwerpunkt Gefäßchirurgie, Klinikum der Universität zu Köln
  • G. Wassmer - Institut für Medizinische Statistik und Epidemiologie, Klinikum der Universität zu Köln
  • J. Brunkwall - Schwerpunkt Gefäßchirurgie, Klinikum der Universität zu Köln

Deutsche Gesellschaft für Chirurgie. 122. Kongress der Deutschen Gesellschaft für Chirurgie. München, 05.-08.04.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05dgch2751

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgch2005/05dgch018.shtml

Published: June 15, 2005

© 2005 Gawenda et al.
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Outline

Text

Introduction

It has been postulated that the intra-abdominal pressure (IAP) produce pressurization inside the aneurysm sac. The present study was designed to investigate whether, and to what extent, aneurysm sac pressure after endoluminal grafting is influenced by the intra-abdominal pressure.

Materials

Experimental study, in vitro. Compliant Latex aneurysms (aneurysm diameter: 60 mm) were inserted into an circulation model. The systemic mean pressure (SPmean) was varied from 50 to 120 mm Hg with pulse pressure of 40 mm Hg. The aneurysms were excluded by a latex sealed woven polyethylene graft. The systemic (SP)and aneurysm sac pressures (ASP) were measured simultaneously. The aneurysm models were placed inside a closed chamber, which was pressurized stepwise (0, 20, and 40 cm H2O), simulating an increasing intra-abdominal pressure.

Results

In the in vitro model endoluminal grafting created a closed cavity without any endoleak, but showed a relevant aneurysm sac pressure. At a systemic mean pressure of 80 mm Hg, the aneurysm sac mean pressure (ASPmean) was 24 mm Hg at median. By simulating an increasing intra-abdominal pressure, the aneurysm sac pressure increased as well. At an intra-abdominal pressure (IAP) of 20 cm H2O the ASPmean was 29 mm Hg, at 40 mm H2O IAP the ASPmean was 34 mmHg.

Discussion

The presented in vitro model demonstrated that the aneurysm sac mean pressure is influenced by the intra-abdominal pressure; increasing intra-abdominal pressure resulted in increasing aneurysm sac pressures as well. These data needs to be considered when studying endotension.