Persistent Thrombocytopenia Indicates Endoleak After Complex Endovascular Aneurysm Repair

Area of Science:

• Vascular Surgery
• Endovascular Repair
• Aortic Aneurysm Treatment

Background:

• High-pressure endoleaks (type I and III) after fenestrated-branched endovascular aneurysm repair (F-BEVAR) increase rupture risk.
• Early detection of these endoleaks is crucial for timely reintervention.

Purpose of the Study:

• To investigate the correlation between persistent thrombocytopenia and high-pressure endoleaks in the early postoperative period following F-BEVAR.

Main Methods:

• Evaluation of patients undergoing F-BEVAR within a physician-sponsored investigational device exemption study.
• Classification of endoleaks as high-pressure (type I or III) or low-pressure (type II) based on early postoperative CT scans.
• Statistical analysis to determine the association between thrombocytopenia (platelet count <100,000/μL) and endoleak presence.

Main Results:

• 14% of patients developed high-pressure endoleaks, and 16% developed low-pressure endoleaks.
• Patients with high-pressure endoleaks showed significantly lower platelet counts from postoperative day 1 through day 4 compared to other groups.
• On postoperative day 4, patients with high-pressure endoleaks were over 12 times more likely to have average platelets <100,000/μL.

Conclusions:

• F-BEVAR patients experiencing high-pressure endoleaks exhibit significantly reduced postoperative platelet counts.
• Aortic imaging is recommended for patients with platelet counts <100,000/μL on postoperative day 4, as 35% may have a high-pressure endoleak requiring intervention.