Type II endoleak after endovascular aneurysm repair
D A Sidloff1, P W Stather, E Choke
1Vascular Surgery Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK. ds343@le.ac.uk
The British Journal of Surgery
|August 14, 2013
Summary
Rupture from type II endoleak after endovascular abdominal aortic aneurysm repair (EVAR) is rare (0.9%). Interventions like translumbar embolization offer higher success rates and fewer complications for type II endoleaks.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Aortic Aneurysm Disease
Background:
- Type II endoleak is a complication following endovascular abdominal aortic aneurysm repair (EVAR).
- Assessing rupture risk and intervention benefits for type II endoleak is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the risk of aortic aneurysm rupture associated with type II endoleak post-EVAR.
- To determine the efficacy and benefits of interventions for managing type II endoleak.
Main Methods:
- Systematic review conducted following PRISMA guidelines.
- Included 32 retrospective studies with 21,744 patients undergoing EVAR.
- Analyzed outcomes including endoleak incidence, spontaneous resolution, sac expansion, interventions, success rates, and complications.
Main Results:
- Type II endoleak occurred in 10.2% of EVAR patients; 35.4% resolved spontaneously.
- Aortic aneurysm rupture occurred in 0.9% of patients with isolated type II endoleak; over a third lacked sac expansion.
- Translumbar embolization showed higher clinical success (81%) and lower recurrence (19%) than transarterial embolization (62.5%, 35.8%) with fewer complications.
Conclusions:
- Rupture from isolated type II endoleak post-EVAR is rare (<1%) but can occur without sac expansion.
- Translumbar embolization is a more successful and safer intervention for type II endoleak compared to transarterial embolization.
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