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Surgery Today
Published in: Surgery Today 1/2016

01-01-2016 | Original Article

Analysis of anatomical risk factors for persistent type II endoleaks following endovascular abdominal aortic aneurysm repair using CT angiography

Authors: Masayoshi Otsu, Toru Ishizaka, Michiko Watanabe, Takaki Hori, Hiroki Kohno, Keiichi Ishida, Mitsuru Nakaya, Goro Matsumiya

Published in: Surgery Today | Issue 1/2016

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Abstract

Purpose

To predict persistent type II endoleaks (pT2Es) following endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms, we examined factors related to post-EVAR pT2Es.

Methods

Eighty-four cases of EVAR were analyzed. T2Es that persisted for ≥6 months were defined as pT2Es. pT2Es flowing from an inferior mesenteric artery (IMA) and lumbar artery (LA) were termed pIMA-T2Es and pLA-T2Es, respectively. The anatomical factors concerning the aneurysm, IMA and LAs were assessed in the preoperative CT angiography images. A statistical analysis was performed on the factors associated with pT2Es.

Results

The incidence of pT2Es was 25 %. pT2Es were associated with postoperative changes in the aneurysm diameter. A univariate analysis showed that a sac thrombus and the number of patent side branches arising from an aneurysm were significant factors associated with pT2Es. The IMA diameters were significantly larger in cases of pIMA-T2Es. The significant factors associated with pLA-T2Es were a circumferential thrombus, the number of patent LAs and the mean LA diameter. Multivariate analyses indicated that a circumferential thrombus was a protective factor for pT2Es, whereas an IMA ≥2.6 mm and each additional LA branch ≥1.9 mm were powerful risk factors for a pT2E.

Conclusion

Significant anatomical factors associated with pT2E were found in this study. These factors may be useful in selecting patients for perioperative intervention.
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Metadata
Title
Analysis of anatomical risk factors for persistent type II endoleaks following endovascular abdominal aortic aneurysm repair using CT angiography
Authors
Masayoshi Otsu
Toru Ishizaka
Michiko Watanabe
Takaki Hori
Hiroki Kohno
Keiichi Ishida
Mitsuru Nakaya
Goro Matsumiya
Publication date
01-01-2016
Publisher
Springer Japan
Published in
Surgery Today / Issue 1/2016
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-015-1115-5

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