Document Detail

Static sac size with a type II endoleak post-endovascular abdominal aortic aneurysm repair: surveillance or embolization?
MedLine Citation:
PMID:  22617500     Owner:  NLM     Status:  MEDLINE    
A best evidence topic was written according to a structured protocol. The question addressed was whether embolization is superior to surveillance for a type II endoleak associated with a static sac size post-endovascular abdominal aortic aneurysm repair (EVAR). Four hundred and sixty-one papers were identified, of which 10 papers presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, and relevant outcomes and results are tabulated. A review of the available literature suggests that most type II endoleaks are innocuous and will seal spontaneously during the long-term follow-up, even when they persist for more than 6 months. An analysis of the large European Collaborators on Stent-Graft Techniques for Aortic Aneurysm Repair (EUROSTAR) registry that includes prospective data on 2463 patients from 87 European hospitals showed that type II endoleaks were not associated with an increased risk of rupture; this correlates well with the large single-centre studies included in this review. Based on the available evidence, we conclude that the management of most isolated type II endoleaks should be conservative-with close radiological follow-up--even when persistent, with intervention restricted to theoese associated with sac enlargement >5 mm over a 6-month period or >10 mm when compared with pre-EVAR diameter.
Kyriacos Patatas; Lynn Ling; Joel Dunning; Vivek Shrivastava
Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2012-05-22
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  15     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-21     Completed Date:  2013-01-17     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  462-6     Citation Subset:  IM    
Department of Vascular Radiology, Hull Royal Infirmary, Hull, UK.
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MeSH Terms
Aortic Aneurysm, Abdominal / surgery*
Embolization, Therapeutic / methods*
Endoleak / diagnosis*,  therapy
Endovascular Procedures / adverse effects*
Follow-Up Studies
Severity of Illness Index
Tomography, X-Ray Computed

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