Analysis Of Independent Risk Factors Of Digestive System Symptoms After Operation EVAR For Abdominal Aortic Aneurysm

Objective: To retrospectively analyze the factors related to digestive system symptoms present after standard endovascular stent-graft repair(EVAR)on patients with abdominal aortic aneurysm(AAA),thus evaluating the risk factors of digestive system symptoms in AAA patients after EVAR to guide clinical treatment.Methods: According to whether digestive system symptoms occurred from 1 week to 3 months after the surgery,patients with AAA who underwent standard EVAR surgery in the Department of Vascular Surgery,the Affiliated Hospital of Northern Sichuan Medical College from April 2012 to November 2017 were divided into two groups,with and without digestive system symptoms occurring after operation,Using univariate analysis and multivariate analysis,the medical images and clinical data were compared between the two groups;using binary logistic regression analysis and ROC curve analysis,independent risk factors of digestive system symptoms were analyzed;and Pearson correlation was used to detect correlations between independent risk factors.Results: A total of 72 patients were analyzed,of whom 34 cases had digestive system symptoms and 38 cases had no digestive system symptoms.Parameters finally included in the binary logistic model were: the ratio of the maximum diameter of the superior mesenteric artery to the maximum diameter of the inferior mesenteric artery,SMA/IMA(OR,0.143;95%CI,0.026-0.790;P=0.026);the number of small vessels in the abdominal aorta(OR,0.156;95% CI,0.049-0.500;P=0.002);the diameter of closed internal iliac artery,CLA(OR,9.014;95%CI,2.480-32.755;P=0.001);and the ratio of the diameter of closed internal iliac artery to unclosed internal iliac artery,CLA/NCLA(OR,5.361;95%CI,0.356-80.680;P=0.225).ROC curve analysis revealed that SMA/IMA(area under the curve=0.772),number of small vessels in the abdominal aorta(area under the curve=0.807),and CLA(area under the curve=0.863)were highly accurate in predicting the occurrence of digestive system symptoms after EVAR surgery.The Pearson correlation test showed that the SMA/IMA was significantly correlated to the number of small vessels in the abdominal aorta branch(P <0.05).Conclusion: Reduced SMA/IMA,decreased number of small vessels in the abdominal aorta,and increased diameter of CLA are independent risk factors of the digestive system symptoms that may be present after the standard EVAR surgery;SMA/IMA has certain correlation with the number of small blood vessels in the abdominal aorta.For patients with EVAR surgery,only SMA/IMA and CLA diameters could be measured.According to the data,the risk of digestive system symptoms after EVAR was evaluated,and the appropriate surgical scheme(standard EVAR+ branch stent)was selected.