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Sonographic Changes in Optic Nerve Sheath Diameter Associated with Supra‐ versus Infrarenal Aortic Aneurysm Repair
Author(s) -
Ertl Michael,
Schierling Wilma,
Kasprzak Piotr M.,
Kopp Reinhard,
Brückl Corinna,
Schlachetzki Felix,
Pfister Karin
Publication year - 2016
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12385
Subject(s) - medicine , aneurysm , perfusion , aortic repair , surgery , abdominal aortic aneurysm , statistical significance , aortic aneurysm , endovascular aneurysm repair , radiology , anesthesia
BACKGROUND AND PURPOSE Quantification of changes in optic nerve sheath diameter (ONSD) using ocular sonography (OS) constitutes an elegant technique for estimating intracranial and intraspinal pressure. Aortic aneurysm repair (AAR) is associated with a reasonable risk of increased spinal fluid pressure, which is largely dependent on the extent of aneurysm repair (supra‐ vs. infrarenal). The aim of this study was to compare ONSD measurements in patients with suprarenal AAR (sAAR) or infrarenal AAR (iAAR). METHODS Thirty patients who underwent elective endovascular repair of infrarenal aortic aneurysms (Group iAAR) were included in the study; the characteristics in these cases were prospectively analyzed and compared with those in a previously investigated group of 28 patients treated for suprarenal aortic aneurysms (Group sAAR). Six measurements of ONSDs were performed in each patient at five consecutive time points. Statistical analysis was performed using the Wilcoxon test. A P value < .05 was considered statistically significant. RESULTS A highly significant difference between pre‐ and postinterventional values could be detected in both patient groups ( P < .01). In Group sAAR, there was a mean .3‐mm increase of the ONSD, whereas in Group iAAR, a mean .2‐mm decrease could be detected. Both groups roughly reached baseline values by the end of their inpatient stay. CONCLUSIONS ONSD changes seem to be a reliable marker to estimate spinal perfusion. Since OS provides a suitable bedside tool for rapid reevaluation, it may guide physicians in the identification and treatment of patients at high risk for spinal cord ischemia.