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Endoleak: predictive value for aneurysm growth at 3 years
David H Deaton1, Michel S Makaroun, Ronald M Fairman
1Chesapeake Vascular, Anne Arundel Medical Center, Annapolis, MD 21401, USA. deaton@chesapeakevascular.com
Annals of Vascular Surgery
|March 21, 2002
Summary
Endoleak after endovascular aneurysm repair is not a reliable predictor of aneurysm growth. While associated with enlargement, it cannot solely determine treatment effectiveness.
Area of Science:
- Vascular Surgery
- Radiology
- Medical Imaging
Background:
- Endoleak is a radiographic finding post-endovascular aneurysm repair (EVAR).
- The prognostic significance of endoleak on EVAR outcomes remains unclear.
Purpose of the Study:
- To assess the predictive value of endoleak for aneurysm growth after EVAR.
- To determine if endoleak status impacts long-term aneurysm therapy outcomes.
Main Methods:
- Retrospective analysis of 80 patients from a clinical trial for a specific EVAR graft.
- Patients were followed for 3 years with CT scans and ultrasound to detect endoleak (no leak, early leak, late leak).
- Aneurysm diameter changes were measured to assess growth, with 5 mm change defining increase/decrease.
Main Results:
- Most patients with distal type 1 or type 2 endoleak showed stable or shrinking aneurysms.
- Endoleak was a poor predictor of aneurysm growth but statistically linked to enlargement.
- Absence of endoleak predicted lack of growth, though not definitively.
Conclusions:
- Endoleak is a risk factor for aneurysm enlargement post-EVAR, necessitating further etiological investigation.
- Endoleak status alone is insufficient as an endpoint for evaluating EVAR efficacy.