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

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Abstract

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.

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Conflict of interest

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Chiba Kaihin Municipal Hospital, 3-31-1, Isobe, Mihama-ku, Chiba, Chiba, 261-0012, Japan

    Masayoshi Otsu & Mitsuru Nakaya

  2. Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan

    Toru Ishizaka, Michiko Watanabe, Hiroki Kohno, Keiichi Ishida & Goro Matsumiya

  3. Department of Cardiovascular Surgery, Chiba Nishi General Hospital, Chiba, Japan

    Takaki Hori

Authors
  1. Masayoshi Otsu
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  2. Toru Ishizaka
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  3. Michiko Watanabe
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  4. Takaki Hori
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  5. Hiroki Kohno
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  6. Keiichi Ishida
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  7. Mitsuru Nakaya
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  8. Goro Matsumiya
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Correspondence to Masayoshi Otsu.

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Otsu, M., Ishizaka, T., Watanabe, M. et al. Analysis of anatomical risk factors for persistent type II endoleaks following endovascular abdominal aortic aneurysm repair using CT angiography. Surg Today 46, 48–55 (2016). https://doi.org/10.1007/s00595-015-1115-5

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  • DOI: https://doi.org/10.1007/s00595-015-1115-5

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