Factors associated with elimination of type II endoleak during the first year after endovascular aneurysm repair

Σπανός, Κωνσταντίνος; Nana, Petroula; Kouvelos, George; Koutsias, Stylianos; Αrnaoutoglou, Eleni; Giannoukas, Athanasios D.; Matsagkas, Miltiadis

doi:10.1016/j.jvs.2019.01.064

Cited by 15 publications

(5 citation statements)

References 34 publications

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“…In addition, it was concluded that the presence of hostile neck anatomy, infrarenal neck angulation, neck length, and patency of the IMA are not predictive of AAA sac remodeling after EVAR. Surprisingly, the patency of the IMA is not related to AAA sac remodeling even though the IMA is a common origin of persistent type II endoleaks, which has repeatedly been shown to correlate to AAA sac remodeling 7,26,35,36 .…”

Section: Discussionmentioning

confidence: 98%

A systematic review of anatomic predictors of abdominal aortic aneurysm remodeling after endovascular repair

Rijswijk

Jebbink

Zeebregts

et al. 2022

Journal of Vascular Surgery

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionmentioning

confidence: 98%

A systematic review of anatomic predictors of abdominal aortic aneurysm remodeling after endovascular repair

Rijswijk

Jebbink

Zeebregts

et al. 2022

Journal of Vascular Surgery

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“…However, previous studies showed that EL 2 occurrence, sac expansion, and need for reintervention are all affected by anatomic and hemodynamic factors [ 14 , 22 ]. Patients with multiple contributing vessels related to EL 2 and inflow–outflow patterns, as well as the presence and distribution of endoluminal thrombus before repair, may lead to persistent EL 2 and subsequently, multiple reinterventions, and even open conversions, to achieve sac exclusion [ 1 , 4 , 23 , 24 ]. In addition, hemodynamic alterations after a successful embolization may lead to the evolution of new endoleaks, including type 2.…”

Section: Discussionmentioning

confidence: 99%

Early and Mid-Term Outcomes of Transcaval Embolization for Type 2 Endoleak after Endovascular Aortic Repair

Nana,

Panuccio,

Rohlffs

et al. 2024

JCM

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Background: Among the endovascular approaches for the management of endoleak type 2 (EL 2), transcaval embolization (TCE) has shown encouraging outcomes. However, the literature is still limited. This study aimed to present the early and mid-term outcomes of TCE for EL 2 after endovascular aortic repair. Methods: A retrospective, single-center analysis of consecutive patients managed with TCE for EL 2 after standard or complex endovascular aortic repair, from August 2015 to March 2024, was conducted. The indication for TCE was the presence of an EL 2 related to ≥5 mm sac increase, compared to the first imaging after aneurysm exclusion or the smallest diameter during follow-up. Patients managed with TCE for other types of endoleaks were excluded. The primary outcomes were technical and clinical successes during follow-up. Results: Forty-three patients were included (mean age: 75.1 ± 6.0 years, 90.7% males). Technical success was 97.7%. Selective embolization was performed in 48.8% and non-selective in 51.2%. No death was recorded at 30 days. The estimated clinical success was 90.0% (standard error; SE: 6.7%) and the freedom from EL 2 was 89.0% (SE 6.4%) at 36 months. Cox regression analysis showed that the type of embolization (selective vs. non-selective), type of previous repair (f/bEVAR vs. EVAR), and use of anticoagulants did not affect follow-up outcomes. Reinterventions related to EL 2 were performed in 12.5%; three underwent an open conversion. Conclusions: TCE was related to high technical success and limited peri-operative morbidity, regardless of the type of initial endovascular aortic repair. Clinical success was encouraging with reinterventions for EL 2 affecting 12.5% of patients.

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“…Early and accurate diagnosis is very important for the treatment and prognosis of aortic constriction. At present, the clinical diagnosis of aortic constriction often uses chest X-ray, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, contrast, and other imaging methods [8]. Among them, chest radiographs are cheap and suitable for preliminary screening of aortic constriction, but their diagnostic sensitivity is too low.…”

Section: Introductionmentioning

confidence: 99%

Artificial Intelligence Segmentation Model-Based Computed Tomography Angiography Image in the Diagnosis of Congenital Aortic Constriction

Zheng

Shao

Zhou

et al. 2022

Scientific Programming

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This study was to analyze the impacts of the image segmentation model and computed tomography angiography (CTA) on the clinical diagnosis of aortic constriction under the background of artificial intelligence. In this study, 126 patients with congenital aortic constriction (CAC) diagnosed by surgery were selected as the research objects and routine digital subtraction angiography (DSA) and CTA were performed. Then, the traditional active contour model (AC model) was optimized based on the local area information to construct a new image segmentation model for intelligent segmentation and reconstruction of the CTA images of patients. The results revealed that compared with the AC model and the image segmentation model based on region growth (RG model) obtained from angiography segmentation, the algorithm constructed in this study showed a smaller segmentation range for angiography images and more accurate segmentation results. The quantitative data results suggested that the evolution times and running time of the constructed model were less than those of the AC and RG models P < 0.05 . Based on the gold standard of DSA examination results, there were 122 correctly diagnosed cases, 3 missed diagnosed cases, and 1 misdiagnosed by CTA, so the diagnosis coincidence rate was 96.83%. Compared with DSA, the average inner diameter and average pressure difference of patients with precatheter, paracatheter, and postcatheter type were not greatly different in CTA P > 0.05 . The CTA examination suggested there were 154 cases with intracardiac structural abnormalities, with a detection rate of 86.52%; there were 32 cases of cardiac-vascular connection abnormalities, with a detection rate of 100%; and there were 79 extracardiac vascular abnormalities, with the detection rate of 95.18%. It indicated that the optimized image segmentation model based on local area information proposed in this paper has excellent segmentation performance for CT angiography images and has good segmentation effect and efficiency. The CTA based on the artificial intelligence image segmentation model showed a better diagnostic effect on abnormal heart-vascular connection and abnormal extracardiac blood vessels and can be used as an effective examination method for clinical diagnosis of CAC.

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Factors associated with elimination of type II endoleak during the first year after endovascular aneurysm repair

Cited by 15 publications

References 34 publications

A systematic review of anatomic predictors of abdominal aortic aneurysm remodeling after endovascular repair

A systematic review of anatomic predictors of abdominal aortic aneurysm remodeling after endovascular repair

Early and Mid-Term Outcomes of Transcaval Embolization for Type 2 Endoleak after Endovascular Aortic Repair

Artificial Intelligence Segmentation Model-Based Computed Tomography Angiography Image in the Diagnosis of Congenital Aortic Constriction

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