Association of Simple Renal Cysts to Aneurysm Sac Shrinkage in True Thoracic Aortic Aneurysm after Thoracic Endovascular Aortic Repair.

BACKGROUND: An increased prevalence of thoracic aortic aneurysm (TAA) has been demonstrated in patients with SRC; patients with SRC has a less elastic aortic wall than those without SRC. The purpose of this study was to evaluate aneurysm sac shrinkage after thoracic endovascular aortic repair (TEVAR) for true TAA in patients with and without SRC.

METHODS: One hundred-three patients with true aneurysms of the thoracic aorta undergoing TEVAR at our university hospital from November 2013 to December 2021 were included in this study. Aneurysm sac size was compared between that on baseline preoperative computed tomography (CT) and that on postoperative CT scans at 1 year. A change in aneurysm sac size ≥ 5 mm was considered to be significant, whether due to expansion or shrinkage.

RESULTS: The patients were divided into two groups; those with SRC (46 patients [45%]) and those without SRC (57 patients [55%]). At 1 year, there was a significant difference in the proportion of aneurysm sac shrinkage between patients with SRC and those without SRC (23.9% vs. 59.6%, p < 0.001). Patients with SRC showed significantly less aneurysm sac shrinkage than those without SRC (-1.8 ± 5.6 mm vs. -5.1 ± 6.6 mm, p = 0.009). Univariable and multivariable analyses showed that initial sac diameter (OR, 1.08; 95% CI, 1.03-1.14; p = 0.002) and the presence of SRC (odds ratio [OR], 0.15; 95% confidence interval [CI], 0.06-0.40; p < 0.001) were positively and negatively associated with aneurysm sac shrinkage after TEVAR, respectively.

CONCLUSIONS: The presence of SRC was independently associated with failure of aneurysm sac shrinkage after TEVAR for true TAA. This suggests that the presence of SRC may be a predictor for failure of aneurysm sac shrinkage after TEVAR.