Persistent type II endoleak after endovascular aneurysm repair was associated with a significantly higher rate of aneurysm sac enlargement compared to no endoleak (27.4% vs 2.7%; P<0.001).
Cohort (n=17,099)
Yes
Does persistent type II endoleak increase the risk of late adverse events in patients undergoing endovascular abdominal aortic aneurysm repair?
Persistent type II endoleak after endovascular abdominal aortic aneurysm repair is significantly associated with increased risks of sac enlargement, rupture, reintervention, and aneurysm-related mortality.
Absolute Event Rate: 27.4% vs 2.7%
p-value: p=<0.001
Background: We reviewed the results of endovascular aneurysm repair in patients from the Japanese Committee for Stentgraft Management registry to determine the significance of persistent type II endoleak (p-T2EL) and the risk of late adverse events, including aneurysm sac enlargement. Methods: The prospectively captured medical records of 17 099 patients <75 years of age who underwent endovascular aneurysm repair for abdominal aortic aneurysm from 2006 to 2015 were reviewed. Patients were divided into 2 groups (with or without p-T2EL) and compared to examine the correlation between p-T2EL and the occurrence of aneurysm sac enlargement after endovascular aneurysm repair. Results: Of the patients, 4957 (29.0%) had p-T2EL and 12 142 (71.0%) had no p-T2EL (non-T2EL). Mean age was significantly higher ( P <0.001), and there were fewer men ( P <0.001) in the p-T2EL group. Among comorbidities, hypertension ( P =0.019) and chronic kidney disease ( P =0.040) were more prevalent and respiratory disorders were less prevalent ( P <0.001) in the p-T2EL group. From each group, 4957 patients were matched according to propensity score to adjust for differences in patient characteristics. The cumulative incidence rates of abdominal aortic aneurysm–related mortality (p-T2EL: 52 of 4957 1.0% versus non-T2EL: 21 of 12 142 0.2%), rupture (p-T2EL: 38 of 4957 0.8% versus non-T2EL: 13 of 12 142 0.1%), sac enlargement (≥5 mm; p-T2EL: 1359 of 4957 27.4% versus non-T2EL: 332 of 12 142 2.7%), and reintervention (p-T2EL: 739 of 4957 14.9% versus non-T2EL: 91 of 12 142 0.7%) were significantly higher in the p-T2EL than the nonpT2EL group ( P <0.001). Propensity score matching yielded higher estimated incremental risk, including abdominal aortic aneurysm–related mortality, rupture, sac enlargement (≥5 mm), and reintervention for p-T2EL ( P <0.001). Cox regression analysis revealed older age ( P =0.010), proximal neck diameter ( P =0.003), and chronic kidney disease ( P <0.001) as independent positive predictors and male sex as an independent negative predictor ( P =0.015) of sac enlargement. Conclusions: The Japanese Committee for Stentgraft Management registry data show a correlation between p-T2EL and late adverse events, including aneurysm sac enlargement, reintervention, rupture, and abdominal aortic aneurysm–related mortality after endovascular aneurysm repair. Besides p-T2EL, older age, female sex, chronic kidney disease, and dilated proximal neck were associated with sac enlargement.
Seike et al. (Fri,) conducted a cohort in Abdominal aortic aneurysm (n=17,099). Persistent type II endoleak (p-T2EL) vs. No persistent type II endoleak (non-T2EL) was evaluated on Aneurysm sac enlargement (≥5 mm) (p=<0.001). Persistent type II endoleak after endovascular aneurysm repair was associated with a significantly higher rate of aneurysm sac enlargement compared to no endoleak (27.4% vs 2.7%; P<0.001).