Early and Late Outcomes of Ultrasound-Guided Direct Transabdominal Embolization of Isolated Type 2 Endoleaks after Endovascular Aortic Repair.
Aged
Aortic Aneurysm
/ diagnostic imaging
Blood Vessel Prosthesis Implantation
/ adverse effects
Embolization, Therapeutic
/ adverse effects
Endoleak
/ diagnostic imaging
Endovascular Procedures
/ adverse effects
Female
Humans
Italy
Male
Recurrence
Registries
Retrospective Studies
Risk Factors
Sweden
Time Factors
Treatment Outcome
Ultrasonography, Interventional
/ adverse effects
Journal
Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
22
03
2020
revised:
09
04
2020
accepted:
15
04
2020
pubmed:
28
4
2020
medline:
25
11
2020
entrez:
28
4
2020
Statut:
ppublish
Résumé
The aim of this study is to report the early and late outcomes of ultrasound-guided direct transabdominal embolization (UGDTE) of isolated type 2 endoleak (T2EL) after endovascular aneurysm repair (EVAR). Forty-two consecutive T2EL patients were treated between February 2000 and September 2017 by UGDTE after previous EVAR. During the study period, UGDTE was the firs-line technique implemented for treatment of T2EL. All procedures were carried out using the same predefined technique. Aneurysm sac size change from the index treatment, freedom from recurrent endoleak after treatment, demographics, risk factors, and procedural factors were analyzed with univariate analysis. During the study interval, 612 patients underwent standard EVAR for abdominal aortic aneurysm treatment and 111 (18.2%) developed an isolated T2EL. Of these, 42 (6.8%) consecutive patients were deemed suitable and treated with UDGT. Median imaging follow-up duration was 18.7 months. Median fluoroscopic and procedure times were 7 and 58 minutes, respectively. The rate of immediate technical success was 100%. Ten patients (23.8%) underwent reintervention for recurrent T2EL. Freedom from reintervention for T2EL at 1, 2, and 4 years was 81%, 78%, and 71%. No aneurysm-related mortality occurred during the follow-up period. The use of UGDTE for treatment of isolated T2EL after EVAR is a safe and feasible technique when performed by experienced operators, resulting in high technical success and low complication rates in selected patients. Although being effective in obtaining T2EL exclusion, up to one-third of the patients may require repeat intervention during long-term follow-up. Therefore, lifelong surveillance after the procedure is recommended.
Sections du résumé
BACKGROUND
BACKGROUND
The aim of this study is to report the early and late outcomes of ultrasound-guided direct transabdominal embolization (UGDTE) of isolated type 2 endoleak (T2EL) after endovascular aneurysm repair (EVAR).
METHODS
METHODS
Forty-two consecutive T2EL patients were treated between February 2000 and September 2017 by UGDTE after previous EVAR. During the study period, UGDTE was the firs-line technique implemented for treatment of T2EL. All procedures were carried out using the same predefined technique. Aneurysm sac size change from the index treatment, freedom from recurrent endoleak after treatment, demographics, risk factors, and procedural factors were analyzed with univariate analysis.
RESULTS
RESULTS
During the study interval, 612 patients underwent standard EVAR for abdominal aortic aneurysm treatment and 111 (18.2%) developed an isolated T2EL. Of these, 42 (6.8%) consecutive patients were deemed suitable and treated with UDGT. Median imaging follow-up duration was 18.7 months. Median fluoroscopic and procedure times were 7 and 58 minutes, respectively. The rate of immediate technical success was 100%. Ten patients (23.8%) underwent reintervention for recurrent T2EL. Freedom from reintervention for T2EL at 1, 2, and 4 years was 81%, 78%, and 71%. No aneurysm-related mortality occurred during the follow-up period.
CONCLUSIONS
CONCLUSIONS
The use of UGDTE for treatment of isolated T2EL after EVAR is a safe and feasible technique when performed by experienced operators, resulting in high technical success and low complication rates in selected patients. Although being effective in obtaining T2EL exclusion, up to one-third of the patients may require repeat intervention during long-term follow-up. Therefore, lifelong surveillance after the procedure is recommended.
Identifiants
pubmed: 32339679
pii: S0890-5096(20)30330-7
doi: 10.1016/j.avsg.2020.04.011
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
252-260Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.