Risk factors of secondary intervention for type II endoleaks in endovascular aneurysm repair: An 8-year single institution study.
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal
/ diagnostic imaging
Endoleak
/ etiology
Endovascular Procedures
Female
Follow-Up Studies
Humans
Male
Postoperative Complications
/ etiology
Reoperation
/ statistics & numerical data
Retrospective Studies
Risk Factors
Stents
Time Factors
Tomography, X-Ray Computed
Abdominal aortic aneurysm
Endoleak
Endovascular aneurysm repair
Type II endoleaks
Journal
Asian journal of surgery
ISSN: 0219-3108
Titre abrégé: Asian J Surg
Pays: Netherlands
ID NLM: 8900600
Informations de publication
Date de publication:
Jan 2019
Jan 2019
Historique:
received:
18
07
2017
revised:
18
09
2017
accepted:
17
10
2017
pubmed:
19
12
2017
medline:
12
2
2019
entrez:
19
12
2017
Statut:
ppublish
Résumé
The natural history of type II endoleaks (T2ELs) is still not completely understood; however, it is widely accepted that those associated with aneurysmal sac growth are harmful. We aimed to review our experience with T2ELs in endovascular aneurysm repair (EVAR). We retrospectively reviewed electronic medical records of all patients who underwent EVAR for infrarenal-type abdominal aortic aneurysms (AAAs) at a single institution from August 2007 to November 2015. Demographic and clinical data were collected. Preoperative contrast computed tomography scans were reviewed to determine aneurysm morphology (the maximum AAA diameter, number of lumbar arteries that enter the AAA sac, size of the inferior mesenteric artery (IMA), proximal neck diameter, proximal neck angle, existence of thrombosis, presence of atheroma, and existence of rupture). Sixty-two patients underwent EVAR; the follow-up duration was 35.82 ± 31.89 months. There were statistically significant differences in female sex (P = .040), number of lumbar arteries on preoperative computed tomography scans (P = .010), and non-smoking status (P = .031) between patients with and without T2ELs. There were statistically significant differences in the maximum AAA diameter (P = .034) and size of the IMA (P = .043) between patients with and without secondary intervention in T2EL. There was one mortality after EVAR but no mortality associated with T2ELs. A more judicious approach that considers risk factors of T2ELs is needed before EVAR. The risk of secondary intervention in patients developing a T2EL after EVAR could increase with the maximum AAA diameter ≥7 cm or IMA ≥3 mm.
Sections du résumé
BACKGROUND/OBJECTIVES
OBJECTIVE
The natural history of type II endoleaks (T2ELs) is still not completely understood; however, it is widely accepted that those associated with aneurysmal sac growth are harmful. We aimed to review our experience with T2ELs in endovascular aneurysm repair (EVAR).
METHODS
METHODS
We retrospectively reviewed electronic medical records of all patients who underwent EVAR for infrarenal-type abdominal aortic aneurysms (AAAs) at a single institution from August 2007 to November 2015. Demographic and clinical data were collected. Preoperative contrast computed tomography scans were reviewed to determine aneurysm morphology (the maximum AAA diameter, number of lumbar arteries that enter the AAA sac, size of the inferior mesenteric artery (IMA), proximal neck diameter, proximal neck angle, existence of thrombosis, presence of atheroma, and existence of rupture).
RESULTS
RESULTS
Sixty-two patients underwent EVAR; the follow-up duration was 35.82 ± 31.89 months. There were statistically significant differences in female sex (P = .040), number of lumbar arteries on preoperative computed tomography scans (P = .010), and non-smoking status (P = .031) between patients with and without T2ELs. There were statistically significant differences in the maximum AAA diameter (P = .034) and size of the IMA (P = .043) between patients with and without secondary intervention in T2EL. There was one mortality after EVAR but no mortality associated with T2ELs.
CONCLUSIONS
CONCLUSIONS
A more judicious approach that considers risk factors of T2ELs is needed before EVAR. The risk of secondary intervention in patients developing a T2EL after EVAR could increase with the maximum AAA diameter ≥7 cm or IMA ≥3 mm.
Identifiants
pubmed: 29249391
pii: S1015-9584(17)30389-5
doi: 10.1016/j.asjsur.2017.10.003
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
106-111Informations de copyright
Copyright © 2017. Published by Elsevier Taiwan LLC.