Endoleaks following endovascular repair of abdominal aortic aneurysm: The predictive value of preoperative anatomic factors—a review of 100 cases

Abstract

Endoleaks develop in a significant number of endovascularly repaired AAAs. We were unable to demonstrate a statistically significant association with anatomic characteristics thought to predispose to the development of endoleaks. We find no predictive value associated with these anatomic factors.

Management of endoleaks associated with endovascular treatment of descending thoracic aortic diseases

“…Management and treatment of endoleaks associated with endovascular intervention for abdominal aortic aneurysms have been described, but those after thoracic aortic stent grafting are less studied. [2][3][4][5][6][7][8][9][10][11] Still, rates of endoleak after thoracic aortic stent grafting have been thought to be lower than those in the abdominal aorta, where 10% to 25% of patients are affected. [12][13][14][15][16][17][18][19] In the European Collaborators on Stent-Graft Techniques for Thoracic Aortic Aneurysm and Dissection Repair (EUROSTAR) and United Kingdom Thoracic Endograft registries of thoracic aortic stent grafting, endoleaks were relatively infrequent and usually related to graft fixation (type I).…”

“…Although there are considerable data regarding endografting in the abdominal aorta, the etiology of endoleaks remains controversial. [1][2][3][4] The thoracic aortic stent graft is a relative newcomer for use in endovascular intervention, and the anatomic and pathologic challenges in this vascular region differ from those in the abdominal aorta. As yet, the precursors of endoleak after thoracic aortic endovascular interventions are poorly understood.…”

The influence of thrombus, calcification, angulation, and tortuosity of attachment sites on the time to the first graft-related complication after endovascular aneurysm repair

“…9 Thrombus, calcification and angulation at attachment sites, and tortuosity of access vessels are thought to be further important risk factors. 10 However, extent of influence of these factors has not been quantified using conventional imaging techniques. Three-dimensional (3D) image processing overcomes typical limitations of planar reconstruction such as parallax error, an imprecise volume calculation, and reduces measurement variability while interobserver agreement is improved.…”

Endograft Sizing for Abdominal Aortic Aneurysms

“…Still, several studies failed to find any significance between oversizing and endoleaks, including one that investigated those oversized >30% [40,54,59,60]. Several of these studies were difficult to interpret, due to varying population characteristics and methodology.…”

“…In particular, type I (incomplete seal) and III (mechanical failure of the graft) endoleaks are associated with worse outcomes, with type 1A (proximal) leak posing the greatest risk of rupture [14]. Endoleak is amongst the most common failures reported with rates ranging from approximately 5 to 40% [14,[53][54][55]. Furthermore, some authors estimate that endoleaks account for over 60% of EVAR reinterventions [56].…”