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

作者：Otsu Masayoshi^*; Ishizaka Toru; Watanabe Michiko; Hori Takaki; Kohno Hiroki; Ishida Keiichi; Nakaya Mitsuru; Matsumiya Goro

来源：Surgery Today, 2016, 46(1): 48-55.

DOI：10.1007/s00595-015-1115-5

• Abdominal aortic aneurysm
• Endovascular repair
• Type II endoleak
• CT angiography

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.

• 出版日期2016-1