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CardioVascular and Interventional Radiology

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01-08-2011 | Clinical Investigation

Endovascular Treatment of Delayed Type 1 and 3 Endoleaks

Authors: Peter A. Naughton, Manuel Garcia-Toca, Heron E. Rodriguez, Aoife N. Keeling, Scott A. Resnick, Mark K. Eskandari

Published in: CardioVascular and Interventional Radiology | Issue 4/2011

Abstract

Purpose

Endovascular aortic aneurysm repair (EVAR) has revolutionized the treatment of abdominal aortic aneurysms. Type I and III endoleaks require prompt, definitive repair or explantation. We review a single center experience of endovascular treatment of type I and III endoleaks.

Materials and Methods

Retrospective review of 22 patients who underwent endovascular intervention for remediation of proximal or distal seal zone endoleaks.

Results

Median age was 77 years. Median time interval from EVAR to reintervention was 4 years (range, 1 month–11 years). Sixteen patients (73%) had radiological evidence of endoleak and/or expanding sac size and 6 (27%) had contained rupture. Nine patients underwent a total of 12 endovascular reinterventions before this salvage procedure. Stent grafts used at the original procedure were: AneuRx (n = 10), Excluder (n = 7), Ancure (n = 3), Zenith (n = 1), and custom made (n = 1). Endoleaks treated were type Ia (n = 11), Ib (n = 12), and type III (n = 3). Interventions included: proximal cuff insertion with or without Palmaz stent insertion (n = 8), distal limb extension (n = 2), stent graft relining (n = 6), embolization of hypogastric artery and iliac limb extension (ILE) (n = 5), and aorto-uni-iliac stent graft (AUI) with femoral–femoral crossover (n = 1). One patient who had a rupture died of multiorgan failure. Two patients needed additional reinterventions for endoleaks. Median length of hospital stay was 1 day.

Conclusion

Lifelong surveillance after EVAR is advocated because of the potential of delayed type I or III endoleaks, which mandate definitive treatment. Fortunately, most delayed type I and III endoleaks can be successfully corrected with endoluminal interventions rather than resorting to explantation of the endograft.

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Title: Endovascular Treatment of Delayed Type 1 and 3 Endoleaks
Authors: Peter A. Naughton
Manuel Garcia-Toca
Heron E. Rodriguez
Aoife N. Keeling
Scott A. Resnick
Mark K. Eskandari
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: CardioVascular and Interventional Radiology / Issue 4/2011
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-010-0020-y

At a glance: The STEP trials

Springer Medicine

Endovascular Treatment of Delayed Type 1 and 3 Endoleaks

Abstract

Purpose

Materials and Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusion

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