Document Detail


Intraoperative endoleak during EVAR: frequency, nature, and significance.
MedLine Citation:
PMID:  19351648     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Endoleaks are critical complications of endovascular abdominal aortic aneurysm repair (EVAR). This study sought to determine the frequency and nature of intraoperative endoleaks and their impact on postoperative endoleak-related events. METHODS: A retrospective chart review was performed of all patients who underwent EVAR at our institution. The impact of intraoperative endoleaks on postoperative endoleak rates and endoleak-related reintervention rates were assessed. RESULTS: From December 18, 1996, to May 21, 2003, 241 patients underwent EVAR. An endoleak was observed during 126 (52.3%) procedures. Type I endoleaks were observed in 63 (26.1%) cases: 35 proximal and 31 distal endoleaks (3 cases at both attachments). Angioplasty, additional cuff placement, or stenting corrected 59 (89.4%) of these endoleaks. A total of 71 type II intraoperative endoleaks (29.5%) and 8 type IV endoleaks (3.3%) were observed without any attempted corrective maneuvers. Ten type III endoleaks (4.2%) occurred but all resolved with angioplasty or additional cuff placement. In all, 86 (35.7%) endoleaks persisted on completion angiogram. Patients with a type I or type II intraoperative endoleak were more likely to have an endoleak at 1.5 years (31.4% vs. 21.6%, P=.018). Reinterventions were required more often after an intraoperative type I endoleak (10% vs. 4%, P=.003). Patients with intraoperative endoleaks demonstrated a trend toward less postoperative aneurysm diameter reduction at 2 years (43.8% vs. 74.5%, P=.104). CONCLUSION: The presence of a type I or a type II endoleak during EVAR significantly increases the likelihood of a postoperative endoleak and should prompt a high degree of suspicion during follow-up.
Authors:
Sergio M Sampaio; Susanna H Shin; Jean M Panneton; James C Andrews; Thomas C Bower; Kenneth J Cherry; Audra A Duncan; Manju Kalra; Peter Gloviczki
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Publication Detail:
Type:  Journal Article     Date:  2009-04-07
Journal Detail:
Title:  Vascular and endovascular surgery     Volume:  43     ISSN:  1538-5744     ISO Abbreviation:  -     Publication Date:    2009 Aug-Sep
Date Detail:
Created Date:  2009-08-26     Completed Date:  2009-10-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136421     Medline TA:  Vasc Endovascular Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  352-9     Citation Subset:  IM    
Affiliation:
Eastern Virginia Medical School, and Division of Vascular Surgery, Sentara Heart Hospital, Norfolk, Virginia, USA.
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MeSH Terms
Descriptor/Qualifier:
Aortic Aneurysm, Abdominal / diagnosis,  surgery*
Aortography / methods
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*
Equipment Failure Analysis
Humans
Intraoperative Period
Kaplan-Meiers Estimate
Postoperative Period
Prosthesis Design
Prosthesis Failure*
Reoperation
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Tomography, X-Ray Computed
Treatment Failure
Ultrasonography, Doppler, Duplex

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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