alexa Long-term follow-up of type II endoleak embolization reveals the need for close surveillance.
Cardiology

Cardiology

Journal of Cardiovascular Diseases & Diagnosis

Author(s): Sarac TP, Gibbons C, Vargas L, Liu J, Srivastava S,

Abstract Share this page

Abstract OBJECTIVE: Aneurysm growth after endovascular aneurysm repair (EVAR) in patients with type II endoleak is associated with adverse outcomes. This study evaluated the long-term success of embolization of type II endoleaks in preventing aneurysm sac growth. METHODS: We retrospectively reviewed outcomes of patients who underwent infrarenal EVAR who were treated for a type II endoleak between 2000 and 2008. Computed tomography scans were evaluated for aneurysm sac growth or shrinkage from the time of treatment of the endoleak. The embolization material used, graft type, target vessel embolized, and comorbidities were evaluated for their association with sac growth or shrinkage. RESULTS: Ninety-five patients underwent 140 embolization procedures. The mean time from EVAR to embolization was 26.1 ± 22.2 months, and the average increase in size of the aneurysm sac from EVAR to treatment was 0.7 × 0.5 cm. Patients underwent an average of 1.6 ± 0.8 embolization procedures after EVAR. Thirteen patients underwent initial simultaneous embolization of two targets. Embolization was with glue (61\%), coils (29\%), glue and coils (7\%), and Gelfoam (3\%; Pfizer Inc, New York, NY). No abdominal aortic aneurysms (AAA) ruptured. Eight patients (8.4\%) underwent graft explant and open repair; 19 (20\%) required two or more embolization procedures. There was no difference in the target vessel treated or the treatment used in halting sac expansion (>5 mm). Coil embolization alone resulted in more second procedures. The 5-year cumulative survival was 65\% (95\% confidence interval [CI], 52\%-77\%), freedom from explant was 89\% (95\% CI, 81\%-97\%), freedom from second embolization was 76\% (95\% CI, 66\%-86\%), and freedom from sac expansion >5 mm was 44\% (95\% CI 30\%-50\%). Univariable analysis identified continued tobacco use (hazard ratio [HR], 2.30; 95\% CI, 1.02-5.13; P = .04) was associated with continued sac expansion, and hyperlipidemia (HR, 9.64; 95\% CI, 2.22-41.86) was associated with patients requiring a second embolization procedure. CONCLUSIONS: Embolization of type II endoleaks is successful early in preventing aneurysm sac growth and rupture after EVAR. However, a significant number of patients require more than one procedure, and at 5 years, many patients who underwent embolization of a type II endoleak continued to experience sac growth. Patients with hyperlipidemia who undergo coil embolization are more likely to require a second embolization procedure, and patients who smoke have a higher likelihood of AAA sac expansion after embolization. Continued long-term surveillance is necessary in this cohort of patients. Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. This article was published in J Vasc Surg and referenced in Journal of Cardiovascular Diseases & Diagnosis

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

  • 22nd World Cardiology Congress
    December 11-12, 2017 Rome, Italy
  • 2nd World Heart Congress
    May 14-16, 2018 Tokyo, Japan
  • 24th Annual CardiologistsConference
    June 11-13, 2018 Barcelona, Spain
  • 3rd International Conference on Cardiovascular Medicine and Cardiac Surgery
    July 05-06, 2018 Berlin, Germany
  • 24th World CardiologyConference
    September,17-18, 2018, Hong Kong

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

 
© 2008- 2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords