Document Detail


Late-onset type II endoleaks and the incidence of secondary intervention.
MedLine Citation:
PMID:  14712377     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Type II endoleaks are a recognized complication of endoluminal treatment of abdominal aortic aneurysms. In order to better understand the natural history of type II endoleaks and their influence on secondary procedures, we examined our experience with patients who developed isolated type II endoleaks 6 months or more after their original procedure. We conducted a retrospective review of patients who underwent endoluminal repair of infrarenal abdominal aortic aneurysms with bifurcated endoluminal devices at a single institution from June 1996 to June 2000. Endoleak surveillance was performed on all patients by using a defined CT angiogram protocol. Patients with definitive and isolated type II endoleaks on CT angiogram were identified. Patients with indeterminate endoleaks or a combination of different types of endoleaks were excluded. Data were analyzed on the basis of early (<6 months) or late occurrence of isolated type II endoleak. Fifty patients were identified with isolated type II endoleaks. Of these patients, 20 (40%) had endoleaks discovered before the 6-month follow-up interval whereas the majority (60%) had new type II leaks discovered at least 6 months after their initial procedure. The timing of endoleak occurrence did not significantly influence the rate of spontaneous endoleak resolution between the early- (<6 months) and late-onset (>6 months) groups, which was nearly identical (40% vs. 43%). Ten patients in the early group and seven of the late-onset group required secondary intervention for treatment of type II endoleak (50% vs. 23%; NS). Three patients in the early group underwent surgical conversion (vs. 0 patients in the late-onset group). The mortality rate was not significantly different between groups (15% vs. 7%). Most isolated type II endoleaks in this patient population occurred 6 months or more after initial endoluminal repair of infrarenal abdominal aortic aneurysm. Timing of type II endoleak occurrence did not significantly affect the rates of spontaneous resolution or mortality. Although differences were observed in the number of patients receiving secondary interventions, these findings did not reach statistical difference. All patients who required surgical conversion had early type II endoleaks. There were no observed ruptures in patients with increased aneurysm size treated with secondary intervention or those with stable aneurysm volumes who were followed without intervention. The continued development of type II endoleaks beyond the perioperative period supports the need for continued endoleak surveillance.
Authors:
Christopher J Hansen; Benjamin Kim; Ihab Aziz; Ivan A Enriquez; Carlos Donayre; George Kopchok; Irwin Walot; Maurice Lippmann; Rodney A White
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Publication Detail:
Type:  Journal Article     Date:  2004-01-12
Journal Detail:
Title:  Annals of vascular surgery     Volume:  18     ISSN:  0890-5096     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-03-24     Completed Date:  2004-06-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  26-31     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery, Harbor-UCLA Medical Center, Torrance, CA 90509, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anastomosis, Surgical / adverse effects
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects*
Humans
Incidence
Middle Aged
Postoperative Complications*
Prosthesis Failure*
Reoperation
Retrospective Studies
Time Factors

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


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