Spontaneous Delayed Sealing in Selected Patients with a Primary Type-Ia Endoleak After Endovascular Aneurysm Repair

Abstract

All but one of the primary type-Ia endoleaks sealed spontaneously. Until sealing, the risk of rupture persisted, but subsequently only one recurrence of type-Ia endoleak was seen. In selected patients, a conservative approach for primary type-Ia endoleaks may be justified.

Select early type IA endoleaks after endovascular aneurysm repair will resolve without secondary intervention

“…Similar results have been seen in several small series in which >50% of persistent type IA endoleaks have resolved by the first follow-up CT scan. 7,8,10,13 With longer follow-up, only 14% of the endoleaks present at the case end were still present at 1 year. More important, there was no difference in overall survival in those patients who left the operating room with a persistent endoleak compared with those whose endoleaks resolved.…”

“…Recent data suggest that type IA endoleaks may not carry such a dire prognosis as previously believed. Several studies have demonstrated low rates of rupture and aneurysm-related mortality and high rates of spontaneous sealing in select patients, [8][9][10][11][12][13][14] but these studies are limited by small numbers and limited follow-up. The goal of this study was to examine our institutional experience with type IA endoleaks in an effort to document long-term outcomes.…”

Collected Transatlantic Experience From the PERICLES Registry: Use of Chimney Grafts to Treat Post-EVAR Type Ia Endoleaks Shows Good Midterm Results

“…1,2 While intraoperative type Ia endoleaks can resolve spontaneously in some cases, justifying a watchful waiting strategy, late type Ia endoleaks need to be treated because they are strictly associated with sac growth, and ultimately, to aneurysm rupture. [14][15][16] At the moment there is no consensus about the optimal treatment.…”

Management of Immediate Post-Endovascular Aortic Aneurysm Repair Type Ia Endoleaks and Late Outcomes

“…In an evaluation of 15 patients, Bastos and colleagues 30 identified 14 patients who had spontaneous type Ia endoleak closures, with 1 patient ultimately developing a recurrent type Ia endoleak years later, and 1 patient with an unconfirmed recurrent endoleak. Kim and coworkers 18 evaluated 86 patients undergoing EVAR and found spontaneous closure of type Ia endoleaks in 7 of 10 patients, although the median follow-up period was only 14 months.…”