Initial Clinical Experience with Serial Remote Pressure Sensing After Endovascular Aneurysm Repair

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Ross Milner, MD, Karthik Kasirajan, MD, Doug MacMillan, MD, Thomas Dodson, MD, Atef Salam, MD, Elliot Chaikof, MD.
Emory University School of Medicine, Atlanta, GA, USA.

OBJECTIVES:
To review a single-center experience with remote pressure sensing for postoperative surveillance after endovascular abdominal aortic aneurysm repair.
METHODS:
A total of ten patients receiving commercial abdominal endografts were enrolled in this prospective, non-randomized FDA-approved study. The sensor (CardioMEMS, Atlanta, GA) was implanted at the time of endograft insertion. All patients had pressure measurements taken intra-operatively, and on postoperative days 1, 30, and at 6 months. Seven patients were available for six-month measurements.
RESULTS:
All ten patients underwent successful insertion and intraoperative interrogation of the sensor without perioperative device-related complications. At the time of sensor placement three patients had type I endoleaks, which were associated with elevated intrasac pressures that decreased upon intervention in all cases. One patient was noted to have an elevated pulse pressure at 6 months in association with a type III endoleak on CT scan. The endoleak was successfully treated by cuff placement with a marked reduction in pulse pressure. At six months, mean aneurysm diameter was 50 mm compared to a mean preoperative diameter of 53 mm (n=7). Correlative mean intrasac pulse pressure was 23.14 mm Hg (n=7), which contrasted with a mean systemic pulse pressure of 60.29 mm Hg.
CONCLUSIONS:
Early experience with a remote pressure sensor confirms short-term reliability in the absence of device-related adverse events. Further study will be required to determine whether this strategy will assist in limiting the frequency of postoperative CT or Duplex surveillance after endovascular aneurysm repair.

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