Hirotsugu Miyoshi1,2, Hiroshi Hamada3, Ryuji Nakamura3, Takashi Kondo3, Toshimichi Yasuda3, Noboru Saeki3, Masashi Kawamoto3. 1. Department of Anesthesiology and Critical Care, Hiroshima University Hospital, Hiroshima, Japan. miyoshi0728@hotmail.co.jp. 2. Department of Anesthesiology and Critical Care Institution, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. miyoshi0728@hotmail.co.jp. 3. Department of Anesthesiology and Critical Care, Hiroshima University Hospital, Hiroshima, Japan.
Abstract
BACKGROUND: We have noted that patients frequently complain of thoracic or low back pain after undergoing an endovascular aortic repair, which we speculated was caused by the indwelling stent. METHODS: We investigated the patients who underwent an elective thoracic or abdominal endovascular aortic repair (TEVAR or EVAR) and noted the location of stent, and postoperative pain. The incidence of either thoracic or low back pain at individual vertebra levels was determined, after which we fitted the sigmoidal function to the discrete data to obtain a cut-off line. The study patients were then divided into 2 groups using the cut-off line to compare the incidence of pain. RESULTS: We analyzed 96 patients (68 TEVAR, 28 EVAR). The incidence of thoracic pain was significantly higher in TEVAR as compared to EVAR (26.5% vs. 3.6%, P = 0.01), while that of low back pain was significantly higher in EVAR (35.7% vs. 16.2%, P = 0.04). With the cut-off line for thoracic pain set at the 12th thoracic vertebra, the incidence of thoracic pain was significantly higher in patients with the upper end of the stent above the cut-off as compared to at a lower point (26.5% vs. 3.6%, P = 0.01). As for low back pain, the cut-off line was set at the 9th thoracic vertebra, and the incidence of that pain was significantly higher in patients with the lower end of the stent below that line (30.9% vs. 0.0%, P < 0.01). CONCLUSION: Thoracic and low back pain after an endovascular aortic repair procedure were associated with stenting site.
BACKGROUND: We have noted that patients frequently complain of thoracic or low back pain after undergoing an endovascular aortic repair, which we speculated was caused by the indwelling stent. METHODS: We investigated the patients who underwent an elective thoracic or abdominal endovascular aortic repair (TEVAR or EVAR) and noted the location of stent, and postoperative pain. The incidence of either thoracic or low back pain at individual vertebra levels was determined, after which we fitted the sigmoidal function to the discrete data to obtain a cut-off line. The study patients were then divided into 2 groups using the cut-off line to compare the incidence of pain. RESULTS: We analyzed 96 patients (68 TEVAR, 28 EVAR). The incidence of thoracic pain was significantly higher in TEVAR as compared to EVAR (26.5% vs. 3.6%, P = 0.01), while that of low back pain was significantly higher in EVAR (35.7% vs. 16.2%, P = 0.04). With the cut-off line for thoracic pain set at the 12th thoracic vertebra, the incidence of thoracic pain was significantly higher in patients with the upper end of the stent above the cut-off as compared to at a lower point (26.5% vs. 3.6%, P = 0.01). As for low back pain, the cut-off line was set at the 9th thoracic vertebra, and the incidence of that pain was significantly higher in patients with the lower end of the stent below that line (30.9% vs. 0.0%, P < 0.01). CONCLUSION: Thoracic and low back pain after an endovascular aortic repair procedure were associated with stenting site.
Authors: P G Hagan; C A Nienaber; E M Isselbacher; D Bruckman; D J Karavite; P L Russman; A Evangelista; R Fattori; T Suzuki; J K Oh; A G Moore; J F Malouf; L A Pape; C Gaca; U Sechtem; S Lenferink; H J Deutsch; H Diedrichs; J Marcos y Robles; A Llovet; D Gilon; S K Das; W F Armstrong; G M Deeb; K A Eagle Journal: JAMA Date: 2000-02-16 Impact factor: 56.272