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01.11.2015 | original article | Ausgabe 21-22/2015

Wiener klinische Wochenschrift 21-22/2015

Length of abdominal aortic aneurysm and incidence of endoleaks type II after endovascular repair

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 21-22/2015
Autoren:
cand, med Dinh Dong Nghi Phan, Prof. Dr. med. habil. Frank Meyer, Prof. Dr. med. habil. Maciej Pech, Priv-Doz. Dr. med. habil. Zuhir Halloul
Wichtige Hinweise
Dinh Dong Nghi Phan and Frank Meyer were equally involved in conceptual idea, planning and conducting the study, data collection and evaluation besides writing the manuscript draft, its correction as well as repeated proof-reading, therefore, both should be considered as first authors.

Summary

Objective

To evaluate the predicting factors for the development of endoleak type II, its frequency and influencing factors after elective endovascular repair (EVAR) of infrarenal abdominal aortic aneurysms (AAA).

Methods

Data were prospectively collected in a unicenter observational study (tertiary center of [endo-] vascular surgery) and retrospectively evaluated in patients who had undergone elective EVAR of AAA. Vascular (lumbar arteries (LA) and inferior mesenteric artery, aneurysm) and general patient (habits, medication, basic diseases) as well as procedural characteristics, were analyzed for their association with the development of endoleak type II. Pre and postinterventional computed tomography (CT) scans were evaluated for aneurysm anatomy, in particular, postinterventional growth or shrinkage as well detection of an endoleak of each type.

Results

The study cohort included 82 patients (mean age, 72 (52–87) years; 77 men, 93.9 %) throughout 36 months. The median follow-up period was 29.5 months (range, 1–57). Overall, 51 endoleaks type II (62.2 %) were identified at any time during the postinterventional follow-up period. In the Cox regression, AAA length was the only significant predictor (P = 0.024; hazard ratio (HR), 1.07; 95 % confidence interval (CI), 1.01–1.14). Thirteen patients (15.8 %) underwent at least one secondary intervention. Aneurysm growth was observed in four patients because of an endoleak type II (4.9 %). No AAA rupture occurred in association with an isolated endoleak type II.

Conclusion

The preoperative AAA length (correlating with the number of LA) can be considered a risk factor for postinterventional occurrence of endoleak type II prompting to greater attention and possible preemptive therapy.

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