Incidence of endoleaks in patients with infrarenal abdominal aortic aneurysms operated on with the endovascular technique
DOI:
https://doi.org/10.53903/01212095.148Keywords:
Endoleak, Aortic Aneurysm, Abdominal, Aneurysm, Endovascular ProceduresAbstract
Introduction: Endoleaks are the most common complication of endovascular treatment of abdominal and thoracic aortic aneurysms. The objective of this study is to describe the frequency of endoleaks in patients with infrarenal aortic aneurysms treated with endovascular techniques.
Methodology: Retrospective cohort study that included patients from September 1, 2013, to March 1, 2021, with infrarenal aneurysms treated with endovascular therapy at the FOSCAL and FOSCAL international clinics. Demographic data, history, morphological characteristics of the aneurysm neck and sac, type of prosthesis used, presence, and type of endoleak were included. A univariate descriptive analysis was performed. Confidence intervals were reported at 95%.
Results: 99 patients were included, the mean age was 74.37 years, the mean neck length was 29.47 mm, 90.24% had a favorable length (>15 mm); The mean angle was 44.57, 67.86% had a favorable angle (<60º). 28.28% of the patients presented endoleaks, the frequency of type Ia endoleaks was 7.07%, type Ib endoleaks 8.08%, type II 18.37%, type IIIa, and IIIb endoleaks 1, 01%. There were no type IV or type V endoleaks.
Conclusions: The frequency of presentation of endoleaks was 28.28%; the most frequent endoleak is type II 18.37%. slightly lower than that reported in the literature
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References
Bryce Y, Schiro B, Cooper K, Ganguli S, Khayat M, Lam CK, et al. Type II endoleaks: Diagnosis and treatment algorithm. Cardiovasc Diagn Ther. 2018;8(Suppl 1):S131-7.
Kim JY, Choi E, Cho YP, Han Y, Kwon TW. Fate of pure type II endoleaks following endovascular aneurysm repair. Vasc Spec Int. 2019;35(3):129-36.
Chaer RA. Avgerinos E. Endoleak following endovascular aortic repair [internet]. UpToDate. 2020 [citado_ 2022 may 15]. Disponible en: https://www.uptodate.com/contents/endoleak-following-endovascular-aortic-repair
Carino D, Sarac TP, Ziganshin BA, Elefteriades JA. Abdominal aortic aneurysm: Evolving controversies and uncertainties. Int J Angiol. 2018;27(2):58-80.
Conrad MF, Adams AB, Guest JM, Paruchuri V, Brewster DC, Lamuraglia GM, et al. Secondary intervention after endovascular abdominal aortic aneurysm repair. Ann Surg. 2009;250(3):383-9.
Kumar Y, Hooda K, Li S, Goyal P, Gupta N, Adeb M. Abdominal aortic aneurysm: Pictorial review of common appearances and complications. Ann Transl Med. 2017;5(12):1-7.
Stenson KM, Patterson BO, Grima MJ, De Bruin JL, Holt PJE, Loftus I. Midterm results of endovascular aneurysm sealing to treat abdominal aortic aneurysm. J Vasc Surg [Internet]. 2019;69(1):53-62.e1. https://doi.org/10.1016/j.jvs.2018.04.016
Lindholt JS, Norman P. Screening for abdominal aortic aneurysm reduces overall mortality in men. A meta-analysis of the mid- and long-term effects of screening for abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2008;36(2):167-71.
Pitton MB, Schmenger P, Düber C, Neufang A, Thelen M. Systemic pulsatile pressure in type II endoleaks after stent grafting of experimental abdominal aortic aneurysms. Cardiovasc Intervent Radiol. 2003;26(3):283-9.
Dias NV, Ivancev K, Resch TA, Malina M, Sonesson B. Endoleaks after endovas¬cular aneurysm repair lead to nonuniform intra-aneurysm sac pressure. J Vasc Surg. 2007;46(2):197-203.
Nicholls J, Kirkham EN, Haslam L, Paravastu SCV, Kulkarni SR. Significance of preoperative thrombus burden in the prediction of persistent Type II endoleak and re-intervention following infra-renal EVAR. J Vasc Surg [Internet]. 2022. https://doi.org/10.1016/j.jvs.2021.12.069
Ajalat M, Williams R, Wilson SE. The natural history of type 2 endoleaks after endovas¬cular aneurysm repair justifies conservative management. Vascular. 2018;26(5):524-30.
Guo Q, Du X, Zhao J, Ma Y, Huang B, Yuan D, et al. Prevalence and risk factors of type II endoleaks after endovascular aneurysm repair: A meta-analysis. Kirchmair R, editor. PLOS ONE. 2017;12(2):e0170600.
Sidloff DA, Stather PW, Choke E, Bown MJ, Sayers RD. Type II endoleak after endovascular aneurysm repair. Br J Surg. 2013;100(10):1262-70.
Skibba AA, Evans JR, Greenfield DT, Yoon HR, Katras T, Ouriel K, et al. Manage¬ment of late main-body aortic endograft component uncoupling and type IIIa endoleak encountered with the Endologix Powerlink and AFX platforms. J Vasc Surg [Internet]. 2015 [citado: 2022 mar 2];62(4):868-75. Disponible en: https://www.sciencedirect.com/science/article/pii/S0741521415010216
Fujimura N, Ichihashi S, Matsubara K, Shibutani S, Harada H, Obara H, et al. Type IIIb endoleak is not extremely rare and may be underdiagnosed after endovascular aneurysm repair. J Vasc Interv Radiol [Internet]. 2019;30(9):1393-99.e1. https://doi.org/10.1016/j.jvir.2019.03.006
Cassagnes L, Pérignon R, Amokrane F, Petermann A, Bécaud T, Saint-Lebes B, et al. Aortic stent-grafts: Endoleak surveillance. Diagn Interv Imaging. 2016;97(1):19-27. doi: 10.1016/j.diii.2014.12.014.
Endovascular versus open repair of abdominal aortic aneurysm. New Eng J Med. [Internet]. 2010;362(20):1863-71 [citado: 2022 mar 2]. Disponible en: https://www.nejm.org/doi/full/10.1056/NEJMoa0909305
Prinssen M, Verhoeven ELG, Buth J, Cuypers PWM, van Sambeek MRHM, Balm R, et al. A Randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. New Eng J Med. 2004;351(16):1607-18.
Lederle FA, Kyriakides TC, Stroupe KT, Freischlag JA, Padberg FT, Matsumura JS, et al. Open versus endovascular repair of abdominal aortic aneurysm. New Eng J Med. [Internet]. 2019;380(22):2126-35 [citado: 2022 mar 2]. Disponible en: https://www.nejm.org/doi/full/10.1056/NEJMoa1715955
Becquemin J-P. The ACE trial: A randomized comparison of open versus endo¬vascular repair in good risk patients with abdominal aortic aneurysm. J Vasc Surg. 2009;50(1):222-4.
Powell JT, Sweeting MJ, Ulug P, Blankensteijn JD, Lederle FA, Becquemin J-P, et al. Meta-analysis of individual-patient data from EVAR-1, DREAM, OVER and ACE tri¬als comparing outcomes of endovascular or open repair for abdominal aortic aneur
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