Incidence, natural course, and outcome of type II endoleaks in infrarenal endovascular aneurysm repair based on the ENGAGE registry data
Objective - The purpose of this study was to report the incidence, natural history, and outcome of type II endoleaks in the largest prospective real-world cohort to date. - Methods - Patients were extracted from the prospective Endurant Stent Graft Natural Selection Global Postmarket Registry (ENGAG...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2020
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| In: |
Journal of vascular surgery
Year: 2019, Volume: 71, Issue: 3, Pages: 780-789 |
| ISSN: | 1097-6809 |
| DOI: | 10.1016/j.jvs.2019.04.486 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jvs.2019.04.486 Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S0741521419313291 
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| Author Notes: | Martijn L. Dijkstra, Clark J. Zeebregts, Hence J. M. Verhagen, Joep A.W. Teijink, Adam H. Power, Dittmar Bockler, Patrick Peeters, Vicente Riambau, Jean-Pierre Becquemin, and Michel M.P.J. Reijnen for the ENGAGE investigators |
| Summary: | Objective - The purpose of this study was to report the incidence, natural history, and outcome of type II endoleaks in the largest prospective real-world cohort to date. - Methods - Patients were extracted from the prospective Endurant Stent Graft Natural Selection Global Postmarket Registry (ENGAGE). Two groups were analyzed: first, patients with an isolated type II endoleak; and second, patients with a type II endoleak who later presented with a type I endoleak. A health status analysis between patients with an early type II endoleak and patients with no endoleak was performed. Second, an attempt was made to identify risk factors in patients with a type II endoleak who later presented with a type I endoleak. - Results - Through 5 years of follow-up, a total of 197 (15.6%) patients with isolated type II endoleaks were identified. Most were detected within the first 30 days (n = 73 [37.1%]) and through the first year (n = 73 [37.1%]), with the remainder being detected after 1 year of follow-up (n = 51 [25.8%]). Patients with a type II endoleak had a higher incidence of aneurysm growth and more secondary endovascular procedures (15.4% vs 7.5% at 5 years; P < .001). Overall survival was higher in the isolated type II endoleak group compared with patients with no endoleak (77.2% vs 67.0% at 5 years; P = .010). Twenty-two patients (10%) with a type II endoleak were diagnosed with a late type I endoleak (type IA, n = 10; type IB, n = 12), with a secondary intervention rate of 67.5% through 5 years. There was no difference in health status scores between patients with an early type II endoleak and patients without any type of endoleak at 1-year follow-up. - Conclusions - In the ENGAGE registry, isolated type II endoleaks are present in 15.6% of patients during follow-up. The majority do not require secondary intervention, and an early isolated type II endoleak does not have an impact on health status through 1 year. However, a small group of patients with a type II endoleak will present with a type I endoleak, resulting in a high secondary intervention rate and significant risk of aneurysm-related complications. |
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| Item Description: | Available online 20 August 2019 Gesehen am 02.04.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1097-6809 |
| DOI: | 10.1016/j.jvs.2019.04.486 |