Effect of endoleaks on changes in aortoiliac volume after endovascular repair for abdominal aortic aneurysm

To evaluate changes in aortoiliac volume after endovascular repair (EVAR) for abdominal aortic aneurysm (AAA) in patients with and without endoleaks.

We retrospectively analyzed 137 patients who underwent EVAR for AAA. We manually measured the aortoiliac volume on pre-procedural baseline CT angiograms (CTAs) and post-procedural follow-up CTAs. All post-procedural CTAs were evaluated for the presence of endoleaks. Follow-up examinations were grouped into five time points relative to the date of the EVAR procedure and mean aortoiliac volume changes from the baseline were calculated.

In 51 patients (37.2%), endoleaks were detected during follow-up. In patients without any endoleaks, mean aortoiliac volume decreased by 21.1% from the pre-interventional baseline examination to the last follow-up examination. In patients with any endoleak during follow-up aortoiliac volume increased by 12.2% and in patients with only transient, post-procedural endoleaks (n = 18), aortoiliac volume decreased by 13.4% over the same time period.

After EVAR for AAA, aortoiliac volume on CT angiography decreases by approximately 20% over time in the absence of endoleaks and increases in the presence of endoleaks. Transient post-procedural endoleaks, however, do not influence long-term volume regression.