Are intrasac pressure measurements useful after endovascular repair of abdominal aortic aneurysms?

Few would argue with the need for long-term follow-up after endovascular repair of abdominal aortic aneurysms. A small risk of reintervention persists and the challenge remains to identify those patients that will require additional procedures to prevent subsequent complications. The ideal follow-up regimen remains elusive. Up until this point, most regimens have consisted of radiologic imaging, with either computed tomography (CT) scans or ultrasonography to identify continued aneurysm perfusion (endoleaks) and document sac dynamics, either shrinkage, growth, or stability. However, aneurysm sac growth or shrinkage serves only as a surrogate measurement for pressurization, and although it is uniformly believed that attachment site endoleaks require treatment, it remains controversial as to how to determine which type II endoleaks pressurize an aneurysm sufficiently to require therapy. In response to these difficulties, several manufacturers have developed pressure sensors that can be implanted at the time of the initial repair. They have been shown capable of measuring intrasac pressures that have appropriately responded to reinterventions for endoleaks. However, are they the answer we are looking for? Are they ready for widespread use? Do they offer a reliable and consistent measure of intrasac pressure that can be trusted to determine the need, or lack of need, for further therapy? Our debaters will try to convince us one way or another.