Real-World Experience with Type I Endoleaks after Endovascular Repair of the Thoracic Aorta
Authors: Adams, Joshua D.; Tracci, Margaret C.; Sabri, Sahir; Cherry, Kenneth J.; Angle, John F.; Matsumoto, Alan H.; Kern, John A.
Source: The American Surgeon, Volume 76, Number 6, June 2010 , pp. 599-605(7)
Publisher: Southeastern Surgical Congress
Abstract:Endoleaks are a frequent complication of thoracic endovascular aortic repair (TEVAR) and will likely increase in incidence with application of the technique to more complicated aortic anatomy and a wider range of thoracic aortic pathologies. Management generally consists of aggressive repair of Type I endoleaks; however, the natural history of Type I endoleaks after TEVAR remains largely unknown. The purpose of this study was to examine the incidence and characteristics of Type I endoleaks and to evaluate clinical outcomes of patients with Type I endoleaks after TEVAR. A single-center retrospective review was performed on all patients who underwent TEVAR over a 4-year period. Type I endoleaks were detected in 21 per cent (27 of 129) of patients on postdeployment aortography or CT angiography. During a mean follow-up of 750.63 ± 483 days, 59 per cent (16 of 27) closed spontaneously; 30 per cent (eight of 27) required secondary endovascular intervention; and 11 per cent (three of 27) have persisted with no increase in maximum aortic diameter. No patients have died or required open surgical conversion as a result of their Type I endoleak. Although accurate predictors of spontaneous resolution of Type I endoleaks have yet to be definitively characterized, our initial results suggest that it may be safe to observe small Type I endoleaks given that a large percentage resolve spontaneously and no endoleak-related deaths have occurred.
Document Type: Research Article
Affiliations: Department of Radiology, University of Virginia Health System, Charlottesville, Virginia, USA
Publication date: June 1, 2010
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