Risk factors of secondary intervention for type II endoleaks in endovascular aneurysm repair: An 8-year single institution study
Summary: Background/Objectives: 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). Meth...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-01-01
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| Series: | Asian Journal of Surgery |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958417303895 |
| _version_ | 1828351433111502848 |
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| author | Up Huh Chung Won Lee Sung Woon Chung Sang-pil Kim Seunghwan Song Miju Bae Jonggeun Lee Chang Won Kim |
| author_facet | Up Huh Chung Won Lee Sung Woon Chung Sang-pil Kim Seunghwan Song Miju Bae Jonggeun Lee Chang Won Kim |
| author_sort | Up Huh |
| collection | DOAJ |
| description | Summary: Background/Objectives: 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: 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: 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: 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. Keywords: Abdominal aortic aneurysm, Endoleak, Endovascular aneurysm repair, Type II endoleaks |
| first_indexed | 2024-04-14T01:39:08Z |
| format | Article |
| id | doaj.art-0c8cc346f56f4561ac269f5571c654a1 |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-04-14T01:39:08Z |
| publishDate | 2019-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-0c8cc346f56f4561ac269f5571c654a12022-12-22T02:19:50ZengElsevierAsian Journal of Surgery1015-95842019-01-01421106111Risk factors of secondary intervention for type II endoleaks in endovascular aneurysm repair: An 8-year single institution studyUp Huh0Chung Won Lee1Sung Woon Chung2Sang-pil Kim3Seunghwan Song4Miju Bae5Jonggeun Lee6Chang Won Kim7Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Corresponding author. Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan 49241, Republic of Korea. Fax: +82 51 243 9389.Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, Republic of KoreaDepartment of Radiology, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of KoreaSummary: Background/Objectives: 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: 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: 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: 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. Keywords: Abdominal aortic aneurysm, Endoleak, Endovascular aneurysm repair, Type II endoleakshttp://www.sciencedirect.com/science/article/pii/S1015958417303895 |
| spellingShingle | Up Huh Chung Won Lee Sung Woon Chung Sang-pil Kim Seunghwan Song Miju Bae Jonggeun Lee Chang Won Kim Risk factors of secondary intervention for type II endoleaks in endovascular aneurysm repair: An 8-year single institution study Asian Journal of Surgery |
| title | Risk factors of secondary intervention for type II endoleaks in endovascular aneurysm repair: An 8-year single institution study |
| title_full | Risk factors of secondary intervention for type II endoleaks in endovascular aneurysm repair: An 8-year single institution study |
| title_fullStr | Risk factors of secondary intervention for type II endoleaks in endovascular aneurysm repair: An 8-year single institution study |
| title_full_unstemmed | Risk factors of secondary intervention for type II endoleaks in endovascular aneurysm repair: An 8-year single institution study |
| title_short | Risk factors of secondary intervention for type II endoleaks in endovascular aneurysm repair: An 8-year single institution study |
| title_sort | risk factors of secondary intervention for type ii endoleaks in endovascular aneurysm repair an 8 year single institution study |
| url | http://www.sciencedirect.com/science/article/pii/S1015958417303895 |
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