Type II endoleaks after endovascular repair of abdominal aortic aneurysm : a single-center experience

Abstract EN

Objective: To determine the incidence of type II endoleaks (T2E) and the results in patients who had endovascular aortic aneurysm repair (EVAR).

Methods: A series of 234 patients who underwent EVAR consecutively at King Hussein Medical Center were retrospectively studied during five years.

Analysis of medical records, computed tomography angiography and procedure angiograms was performed.

Furthermore, the incidence of type II endoleaks, the number of all feeding and draining arteries, aneurysm enlargement and outcomes were analyzed.

Results: The median follow up duration was 20 months range (6-58 months).

The median age was 71 years and 182 were males.

We identified 46/234 (19.7%) patients with type II endoleaks, out of these 22/46 patients (47.8%) had spontaneous resolution during the follow up period and 21/46 patients (45,7%) the aneurysm sac size was unchanged.

Only 3/46 patients (6.5%) developed sac enlargement needed re-intervention.

7 (15%) Patients with more than one source of Type II endoleak had significant failure rate for resolution in < 180 days (p value =0.04).

Furthermore, we identified 36/46 (78%) with T2E had presence of intramural thrombus.

We compared transient T2E vs persistent T2E in cases with the presence of intramural sac thrombus.

There was significant difference between patients with transient T2E (61%) and patients with persistent T2E (36%) with regard to presence of thrombus P<0.01).

The Overall patient mortality during the study period was 16 (7% patients), all deaths were aneurysm unrelated Conclusion: Our data suggests that type II endoleaks are the most common endoleaks in patients who have undergone EVAR.

Not all endoleaks type II are benign so continued long-term surveillance and selective intervention is necessary in this cohort of patients, particularly in patients with sac growth, absence of thrombus, multiple collaterals and persistent endoleaks