Prognostic Utility of Perivascular Adipose Tissue Attenuation in Patients Undergoing Endovascular Aneurysm Repair for Abdominal Aortic Aneurysms

BACKGROUND: Perivascular adipose tissue (PVAT) attenuation on computed tomography angiography reflects vascular inflammation. However, its prognostic value in patients undergoing endovascular aortic repair (EVAR) for abdominal aortic aneurysm (AAA) remains unclear. METHODS: We retrospectively studied consecutive patients who underwent EVAR for unruptured infrarenal AAA with preprocedural computed tomography angiography. PVAT attenuation and aortic characteristics were assessed using computed tomography angiography. The primary outcome was major adverse cardiac or cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, stroke, and any vessel treatment. RESULTS: Among 275 patients treated with EVAR, 35.6% (98/275) experienced MACCE during a median follow-up of 3.5 years. Pre-EVAR PVAT attenuation was higher in patients who experienced MACCE than in those who did not (−69.8±10.3 HU versus −77.3±8.6 HU; P