Type II Endoleak: Conservative Management Is a Safe Strategy

Sidloff, David; Gokani, V.J.; Stather, P.W.; Choke, E.; Bown, Matthew J.; Sayers, R.D.

doi:10.1016/j.jvs.2014.08.099

Cited by 36 publications

(56 citation statements)

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“…As shown in other studies, most EL-2 seen at completion of EVAR thrombose spontaneously. 7 In this study, 63% of EL-2 seen at the intraoperative completion angiogram resolved at the 1-month follow-up. It is likely because of this that the presence of an intraoperative EL-2 had no influence on AAA sac volume change at 6 or 12 months.…”

Section: Discussionmentioning

confidence: 51%

Role of type II endoleak in sac regression after endovascular repair of infrarenal abdominal aortic aneurysms

Kray

Kirk

Franko

et al. 2015

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 51%

Role of type II endoleak in sac regression after endovascular repair of infrarenal abdominal aortic aneurysms

Kray

Kirk

Franko

et al. 2015

Journal of Vascular Surgery

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“…6,7,10,11 Some physicians selectively treat T2EL with sac enlargement >5 mm 4,12 ; others recommended less aggressive management to observe T2EL. 13 AAA sac expansion after EVAR >5 mm at 1 year was reported to be an independent predictor of late mortality regardless of the presence or absence of EL. 14 Several studies reported that intraoperative or preoperative IMA embolization, LA embolization, and aneurysm sac embolization before EVAR were associated with a reduced occurrence of T2ELs or greater shrinkage of the aneurysm sac's diameter.…”

Section: Discussionmentioning

confidence: 91%

Flow dynamics of type II endoleaks can determine sac expansion after endovascular aneurysm repair using four-dimensional flow-sensitive magnetic resonance imaging analysis

Katahashi

Sano

Takehara

et al. 2019

Journal of Vascular Surgery

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Objective: The objective of this study was to investigate the hemodynamic parameters of type II endoleaks (T2ELs) to predict sac expansion using four-dimensional flow-sensitive magnetic resonance imaging (4D-flow MRI) analysis. Methods: Patients who underwent endovascular aneurysm repair (EVAR) and were diagnosed with a T2EL were included in the study. Using 4D-flow MRI at 7 days, the peak flow velocity and amplitude of dynamics of blood flow per minute were measured in each T2EL vessel. The peak flow velocity was defined as the maximum of the absolute value of the blood flow velocity. The amplitude of dynamics of blood flow in the tributary arteries was defined as the sum of the absolute values of the inflow and outflow volume in each vessel. The amplitude of dynamics of blood flow in the tributary arteries per sac was calculated in each sac. The aneurysm sac diameter was measured by computed tomography (CT) at 1 year. The patients were divided into two groups according to the presence or absence of sac expansion. Results: Of 155 patients who underwent EVAR, both CT angiography and 4D-flow MRI were performed in 107 patients at 7 days after EVAR. Among them, 39 (36.4%) were found to have a T2EL, of whom 28 were re-evaluated with CT angiography and 4D-flow at 1 year; 7 patients had expanding sacs (expanding group), whereas 21 had nonexpanding sacs (not-expanding group). At 7 days, 28 patients had 80 T2EL vessels detected by 4D-flow MRI, of which 39 vessels (48.8%) had stopped flowing at 1 year (transient vessels); 41 vessels (51.3%) had sustained flow (persistent vessels). The persistent vessels had significantly larger peak flow velocity and amplitude of dynamics of blood flow. The comprehensive analysis of T2EL vessels per sac identified that the amplitude of dynamics of blood flow in the tributary arteries per sac was significantly higher in the expanding group than in the not-expanding group. A receiver operating characteristic curve analysis revealed that the sensitivity and specificity of sac enlargement at a cutoff value of 3750 mm 3 /min were 85.7% and 76.2%, respectively. Conclusions: The fate of aneurysm sacs with T2ELs after EVAR has remained difficult to predict. A comprehensive analysis of concurrent multiple T2EL vessels using 4D-flow MRI analysis may enable prediction of the sac expansion after EVAR.

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“…En el reciente número de octubre, del Eur J Vasc Endovasc Surg, Sidloff at al. 7 defienden el tratamiento conservador de las EFII ya que no detectan un incremento de la mortalidad relacionada con el aneurisma en pacientes con EFII. Sin embargo, siguen existiendo otras largas series americanas 8 donde consideran que deben ser tratadas para evitar la rotura del saco aneurismático en el seguimiento.…”

Section: Sr Directorunclassified

¿Es la carga de trombo y su localización en el saco un factor protector de endofugas tipo II?

Espada¹,

Palomino²

2015

Angiología

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Type II Endoleak: Conservative Management Is a Safe Strategy

Cited by 36 publications

References 0 publications

Role of type II endoleak in sac regression after endovascular repair of infrarenal abdominal aortic aneurysms

Role of type II endoleak in sac regression after endovascular repair of infrarenal abdominal aortic aneurysms

Flow dynamics of type II endoleaks can determine sac expansion after endovascular aneurysm repair using four-dimensional flow-sensitive magnetic resonance imaging analysis

¿Es la carga de trombo y su localización en el saco un factor protector de endofugas tipo II?

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