Related Experiment Videos
Predicting aneurysm enlargement in patients with persistent type II endoleaks.
Carlos H Timaran1, Takao Ohki, Soo J Rhee
1Division of Vascular Surgery, Department of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, 111E 210th Street, Bronx, NY 10467, USA.
Journal of Vascular Surgery
|June 12, 2004
Summary
Persistent type II endoleaks after endovascular aortic aneurysm repair (EVAR) can lead to aneurysm enlargement. The maximum diameter of the endoleak cavity (nidus) is a key predictor of growth, suggesting closer monitoring and earlier intervention.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Aortic Aneurysm Disease
Background:
- Type II endoleaks after endovascular aortic aneurysm repair (EVAR) have uncertain clinical significance.
- Some evidence suggests type II endoleaks may cause aneurysm enlargement and rupture.
- Identifying predictors of aneurysm expansion is crucial for patient management.
Purpose of the Study:
- To identify factors contributing to aneurysm expansion in patients with persistent type II endoleaks post-EVAR.
- To analyze the influence of various variables on aneurysm growth.
Main Methods:
- Analysis of 348 EVARs over 10 years, focusing on 32 patients with persistent type II endoleaks (>6 months).
- Variables included EVAR reporting standards and endoleak characteristics.
- Statistical analyses: Univariate, receiver operating characteristic (ROC) curve, and Cox regression.
Main Results:
- Aneurysm enlargement (≥5 mm) occurred in 41% of patients.
- Maximum endoleak cavity (nidus) diameter significantly predicted aneurysm enlargement (RR, 1.12; P=.001).
- A nidus diameter >15 mm was strongly associated with increased risk (RR, 11.1; P=.02).
Conclusions:
- The maximum nidus diameter is a significant predictor of aneurysm growth in persistent type II endoleaks post-EVAR.
- This finding may guide more aggressive surveillance and earlier treatment strategies.
- Other analyzed risk factors did not predict aneurysm enlargement.