Clinical significance of type II endoleaks after thoracic endovascular aortic repair
Background - To evaluate the clinical significance of type II endoleaks (ELII) after thoracic endovascular aortic repair (TEVAR). - Methods - From January 1997 to June 2012, a total of 344 patients received TEVAR in our institution. ELII was diagnosed in 30 patients (8.7%; 13 males; median age: 65 y...
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| Hauptverfasser: | , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
14 May 2013
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| In: |
Journal of vascular surgery
Year: 2013, Jahrgang: 58, Heft: 3, Pages: 643-650 |
| ISSN: | 1097-6809 |
| DOI: | 10.1016/j.jvs.2013.03.026 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jvs.2013.03.026 Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S074152141300640X 
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| Verfasserangaben: | Moritz S. Bischoff, MD, Philipp Geisbüsch, MD, Drosos Kotelis, MD, Matthias Müller-Eschner, MD, Alexander Hyhlik-Dürr, MD, and Dittmar Böckler, MD |
| Zusammenfassung: | Background - To evaluate the clinical significance of type II endoleaks (ELII) after thoracic endovascular aortic repair (TEVAR). - Methods - From January 1997 to June 2012, a total of 344 patients received TEVAR in our institution. ELII was diagnosed in 30 patients (8.7%; 13 males; median age: 65 years, range: 24 to 84 years), representing the study population of this retrospective, single-center analysis. Mean follow-up was 29.5 months (range, 8 months to 9.5 years). - Results - Primary ELII was observed in all but two cases (28/30; 93.3%). The most common sources of ELII were the left subclavian artery (LSA; 13/30; 43.3%) and intercostal/bronchial vessels (13/30; 43.3%), followed by visceral arteries (4/30; 13.4%). Overall mortality was 33.3% (10/30). ELII-related death (secondary rupture) was observed in 20% (2/10). Reintervention (RI) procedures for ELII were performed in 9 of 30 patients (30.0%); 5 of 9 (55.6%) in cases with ELII via the LSA. Indications for RI were diameter expansion in five and extensive leakage in four cases. Treatment was successful in five patients (55.6%) but failed in four cases (44.4%). In 12 of 21 (57.1%) untreated patients, ELII sealed during follow-up. In conservatively treated patients, an increase in aortic diameter has been only observed in a patient with secondary ELII. - Conclusions - The results presented herein suggest that the clinical impact of ELII after TEVAR must not be underestimated. Albeit a transient finding in most cases, ELII is associated with a relevant RI rate, particularly in cases involving the LSA. RI seems indicated in patients with increasing aortic diameter and/or extensive leakage. Careful surveillance of all patients with ELII is recommended. |
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| Beschreibung: | Gesehen am 26.11.2020 |
| Beschreibung: | Online Resource |
| ISSN: | 1097-6809 |
| DOI: | 10.1016/j.jvs.2013.03.026 |