Objective: To investigate the risk factors for endoleaks after endovascular aortic repair (EVAR) of abdominal aortic aneurysm (AAA). Methods: A total of 272 patients with AAA undergoing EVAR from January 2014 to October 2015 were retrospectively analyzed. The patients were followed up at postoperative 3, 6, 12, 24, and 36 months. The endoleak incidence and the association of endoleak with clinical characteristics, stent graft type and anatomic geometry of aneurysm neck were analyzed. Results: The incidence of endoleaks after EVAR in 272 patients with AAA was 15.8% (43/272) with 7.4% (20/272), 6.2% (17/272), 1.5% (4/272) and 0.7% (2/272) for type Ⅰ, Ⅱ, Ⅲ+Ⅳ and Ⅴ (endotension), respectively-Type Ⅰ endoleak was found mostly during 3-month of follow-up, and the other endoleaks during 12-month of follow-up or longer. Short proximal neck length of aneurysm (<1.5 cm), oversize degree (>45°), irregular shape, and high calcification (>25%) were significantly associated with an increased incidence of type Ⅰa endoleak (P<0.05). Patent inferior mesenteric artery and ≥2 crime arteries were the risk factors for type Ⅱ endoleak (P<0.05). Clinical characteristics, including age, ASA status, smoking status, and comorbidities such as hypertension, diabetes, coronary artery disease and pulmonary disease had no impact on endoleak. However, stent graft type was associated with the incidence of overall endoleak significantly (P=0.047). Endurant showed to be used with the lowest incidence of endoleak (10.7%) when compared with other stent graft types. Conclusions: To avoid endoleak, physicians should evaluate the characteristics of AAA and assess the risks for endoleak when planning an EVAR.
KANG Pengfei, MAO Le, ZHU Ting, FU Weiguo
. Analysis of different types of endoleak after endovascular repair for abdominal aortic aneurysm: a report of 272 cases[J]. Journal of Surgery Concepts & Practice, 2018
, 23(03)
: 274
-278
.
DOI: 10.16139/j.1007-9610.2018.03.018
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