Endotension Following Endovascular Aneurysm Repair: Retrospective Review of Treatment and Clinical Outcome
Purpose: Endotension is a rare late complication characterized by an increase in sac size without any type of endoleak following endovascular aortic aneurysm repair (EVAR). Due to its rarity, few studies have demonstrated the mechanism behind and the management of endotension. In this study, we aime...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Medrang
2024-03-01
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| Series: | Vascular Specialist International |
| Subjects: | |
| Online Access: | http://www.vsijournal.org/journal/view.html?doi=10.5758/vsi.230108 |
| _version_ | 1797245015955603456 |
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| author | Joon-Young Kim Sang Ah Lee Jun Gyo Gwon Youngjin Han Yong-Pil Cho Tae-Won Kwon |
| author_facet | Joon-Young Kim Sang Ah Lee Jun Gyo Gwon Youngjin Han Yong-Pil Cho Tae-Won Kwon |
| author_sort | Joon-Young Kim |
| collection | DOAJ |
| description | Purpose: Endotension is a rare late complication characterized by an increase in sac size without any type of endoleak following endovascular aortic aneurysm repair (EVAR). Due to its rarity, few studies have demonstrated the mechanism behind and the management of endotension. In this study, we aimed to better understand the treatment and the long-term outcome of endotension in a single-center cohort. Materials and Methods: This study was designed for a retrospective review of the patients diagnosed with endotension between January 2006 and December 2017. The study patients were categorized into two groups (primary versus secondary) based on the presence of any type of endoleak before the diagnosis of endotension. We collected data related to endotension treatment, intraoperative findings, and long-term outcomes. Results: In a cohort of 15 patients diagnosed with endotension following EVAR, eight were classified into the primary endotension (PE) group without prior endoleak, and seven exhibited secondary endotension (SE). Among the eight PE patients, endovascular intervention for a preemptive purpose was conducted in six patients; however, three (50%) showed continuous sac expansion and finally received open conversion. Overall, eight patients (five in PE and three in SE) underwent open conversion, and one (12.5%) presented with an undetected endoleak during the operative findings. Postoperative morbidity was observed in three patients with no operative mortality. Conclusion: Endotension can be managed initially through simple observation for changes on serial images, along with preemptive endovascular intervention. However, surgical intervention should be considered for patients with specific indications including continuous aneurysm sac enlargement, presence of symptoms, suspicions of migration of stent-graft with endoleak, and infection. |
| first_indexed | 2024-04-24T19:20:11Z |
| format | Article |
| id | doaj.art-df707d37bd384f42863744f9339a1306 |
| institution | Directory Open Access Journal |
| issn | 2288-7970 2288-7989 |
| language | English |
| last_indexed | 2024-04-24T19:20:11Z |
| publishDate | 2024-03-01 |
| publisher | Medrang |
| record_format | Article |
| series | Vascular Specialist International |
| spelling | doaj.art-df707d37bd384f42863744f9339a13062024-03-26T03:27:47ZengMedrangVascular Specialist International2288-79702288-79892024-03-014010.5758/vsi.230108vsi.230108Endotension Following Endovascular Aneurysm Repair: Retrospective Review of Treatment and Clinical OutcomeJoon-Young Kim0Sang Ah Lee1Jun Gyo Gwon2Youngjin Han3Yong-Pil Cho4Tae-Won Kwon5Division of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDivision of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDivision of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDivision of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDivision of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Transplantation and Vascular Surgery, Korea University Guro Hospital, Seoul, KoreaPurpose: Endotension is a rare late complication characterized by an increase in sac size without any type of endoleak following endovascular aortic aneurysm repair (EVAR). Due to its rarity, few studies have demonstrated the mechanism behind and the management of endotension. In this study, we aimed to better understand the treatment and the long-term outcome of endotension in a single-center cohort. Materials and Methods: This study was designed for a retrospective review of the patients diagnosed with endotension between January 2006 and December 2017. The study patients were categorized into two groups (primary versus secondary) based on the presence of any type of endoleak before the diagnosis of endotension. We collected data related to endotension treatment, intraoperative findings, and long-term outcomes. Results: In a cohort of 15 patients diagnosed with endotension following EVAR, eight were classified into the primary endotension (PE) group without prior endoleak, and seven exhibited secondary endotension (SE). Among the eight PE patients, endovascular intervention for a preemptive purpose was conducted in six patients; however, three (50%) showed continuous sac expansion and finally received open conversion. Overall, eight patients (five in PE and three in SE) underwent open conversion, and one (12.5%) presented with an undetected endoleak during the operative findings. Postoperative morbidity was observed in three patients with no operative mortality. Conclusion: Endotension can be managed initially through simple observation for changes on serial images, along with preemptive endovascular intervention. However, surgical intervention should be considered for patients with specific indications including continuous aneurysm sac enlargement, presence of symptoms, suspicions of migration of stent-graft with endoleak, and infection.http://www.vsijournal.org/journal/view.html?doi=10.5758/vsi.230108abdominal aortic aneurysmblood vessel prosthesis implantationendoleak |
| spellingShingle | Joon-Young Kim Sang Ah Lee Jun Gyo Gwon Youngjin Han Yong-Pil Cho Tae-Won Kwon Endotension Following Endovascular Aneurysm Repair: Retrospective Review of Treatment and Clinical Outcome Vascular Specialist International abdominal aortic aneurysm blood vessel prosthesis implantation endoleak |
| title | Endotension Following Endovascular Aneurysm Repair: Retrospective Review of Treatment and Clinical Outcome |
| title_full | Endotension Following Endovascular Aneurysm Repair: Retrospective Review of Treatment and Clinical Outcome |
| title_fullStr | Endotension Following Endovascular Aneurysm Repair: Retrospective Review of Treatment and Clinical Outcome |
| title_full_unstemmed | Endotension Following Endovascular Aneurysm Repair: Retrospective Review of Treatment and Clinical Outcome |
| title_short | Endotension Following Endovascular Aneurysm Repair: Retrospective Review of Treatment and Clinical Outcome |
| title_sort | endotension following endovascular aneurysm repair retrospective review of treatment and clinical outcome |
| topic | abdominal aortic aneurysm blood vessel prosthesis implantation endoleak |
| url | http://www.vsijournal.org/journal/view.html?doi=10.5758/vsi.230108 |
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