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Type 2 Endoleaks: Common and Hard to Eradicate yet Benign?

  • CLINICAL INVESTIGATION
  • Arterial Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

The exact significance of type 2 endoleaks (T2ELs) and the indication and efficacy of treatment are widely debated. We report our experience with managing T2ELs in a tertiary Asian centre.

Materials and Methods

This was a retrospective study of patients who underwent endovascular abdominal aortic aneurysm repair (EVAR) between February 2006 and December 2016. Patients with T2ELs were identified, and their data were analysed.

Results

A total of 156 patients underwent EVAR, of which 67 (42.9%) developed T2ELs. Seven were lost to follow-up. The remaining 60 patients had a mean follow-up period of 50.3 ± 33.9 months—34 (56.7%) experienced T2ELs early and the rest (43.3%) had late T2ELs. Forty-one patients had isolated T2EL, whilst 19 had concomitant T1EL and/or T3EL. Spontaneous resolution occurred in 25 patients (41.7%). All T2ELs with stable sac size were on continued surveillance. Amongst those with persistent T2ELs associated with sac growth (n = 17), 14 underwent intervention, of which 7 (50%) received > 1 embolisation procedure. A total of 16 transarterial embolisation and 8 translumbar embolisation procedures were performed. Technical success rate was 75%. In the intervention group, 5 (35.7%) had complete and sustained resolution, 7 had persistent/recurrent T2ELs but stable sac size, and 2 had progressive sac expansion. Overall mortality due to sac rupture occurred in 2 patients with concomitant T2EL and T1EL/T3EL.

Conclusion

T2ELs are common, albeit mostly benign if occurring in isolation and not in association with sac growth. Achieving complete T2EL resolution with embolisation is difficult even with reinterventions.

Level of Evidence

Level 2B, retrospective study

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Acknowledgements

Special thanks are due to Dr. Nurun Nisa De Souza for the advice on statistical analysis.

Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Duke-NUS Medical School, Singapore, Singapore

    Liang Meng Loy

  2. Department of Vascular and Interventional Radiology, Singapore General Hospital, Singapore, Singapore

    Jasmine Ming Er Chua, Farah Gillan Irani, Karthikeyan Damodharan, Sum Leong, Sivanathan Chandramohan, Nanda Venkatanarasimha, Ankur Patel & Kiang Hiong Tay

  3. Department of Vascular Surgery, Singapore General Hospital, Singapore, Singapore

    Tze Tec Chong

  4. Department of Cardiothoracic Surgery, National Heart Centre Singapore, Singapore, Singapore

    Victor Tar Toong Chao

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  1. Liang Meng Loy
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Correspondence to Jasmine Ming Er Chua.

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Loy, L.M., Chua, J.M.E., Chong, T.T. et al. Type 2 Endoleaks: Common and Hard to Eradicate yet Benign?. Cardiovasc Intervent Radiol 43, 963–970 (2020). https://doi.org/10.1007/s00270-020-02497-3

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  • DOI: https://doi.org/10.1007/s00270-020-02497-3

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