PURPOSE: Endovascular aortic aneurysm repair (EVAR) has revolutionized the treatment of abdominal aortic aneurysms. Type I and III endoleaks require prompt, definitive repair or explantation. We review a single center experience of endovascular treatment of type I and III endoleaks. MATERIALS AND METHODS: Retrospective review of 22 patients who underwent endovascular intervention for remediation of proximal or distal seal zone endoleaks. RESULTS: Median age was 77 years. Median time interval from EVAR to reintervention was 4 years (range, 1 month-11 years). Sixteen patients (73%) had radiological evidence of endoleak and/or expanding sac size and 6 (27%) had contained rupture. Nine patients underwent a total of 12 endovascular reinterventions before this salvage procedure. Stent grafts used at the original procedure were: AneuRx (n = 10), Excluder (n = 7), Ancure (n = 3), Zenith (n = 1), and custom made (n = 1). Endoleaks treated were type Ia (n = 11), Ib (n = 12), and type III (n = 3). Interventions included: proximal cuff insertion with or without Palmaz stent insertion (n = 8), distal limb extension (n = 2), stent graft relining (n = 6), embolization of hypogastric artery and iliac limb extension (ILE) (n = 5), and aorto-uni-iliac stent graft (AUI) with femoral-femoral crossover (n = 1). One patient who had a rupture died of multiorgan failure. Two patients needed additional reinterventions for endoleaks. Median length of hospital stay was 1 day. CONCLUSION: Lifelong surveillance after EVAR is advocated because of the potential of delayed type I or III endoleaks, which mandate definitive treatment. Fortunately, most delayed type I and III endoleaks can be successfully corrected with endoluminal interventions rather than resorting to explantation of the endograft.
PURPOSE:Endovascular aortic aneurysm repair (EVAR) has revolutionized the treatment of abdominal aortic aneurysms. Type I and III endoleaks require prompt, definitive repair or explantation. We review a single center experience of endovascular treatment of type I and III endoleaks. MATERIALS AND METHODS: Retrospective review of 22 patients who underwent endovascular intervention for remediation of proximal or distal seal zone endoleaks. RESULTS: Median age was 77 years. Median time interval from EVAR to reintervention was 4 years (range, 1 month-11 years). Sixteen patients (73%) had radiological evidence of endoleak and/or expanding sac size and 6 (27%) had contained rupture. Nine patients underwent a total of 12 endovascular reinterventions before this salvage procedure. Stent grafts used at the original procedure were: AneuRx (n = 10), Excluder (n = 7), Ancure (n = 3), Zenith (n = 1), and custom made (n = 1). Endoleaks treated were type Ia (n = 11), Ib (n = 12), and type III (n = 3). Interventions included: proximal cuff insertion with or without Palmaz stent insertion (n = 8), distal limb extension (n = 2), stent graft relining (n = 6), embolization of hypogastric artery and iliac limb extension (ILE) (n = 5), and aorto-uni-iliac stent graft (AUI) with femoral-femoral crossover (n = 1). One patient who had a rupture died of multiorgan failure. Two patients needed additional reinterventions for endoleaks. Median length of hospital stay was 1 day. CONCLUSION: Lifelong surveillance after EVAR is advocated because of the potential of delayed type I or III endoleaks, which mandate definitive treatment. Fortunately, most delayed type I and III endoleaks can be successfully corrected with endoluminal interventions rather than resorting to explantation of the endograft.
Authors: Suh Min Kim; Hwan Do Ra; Sang-Il Min; Hwan Jun Jae; Jongwon Ha; Seung-Kee Min Journal: Ann Surg Treat Res Date: 2014-01-22 Impact factor: 1.859
Authors: Peter A Naughton; Michael S Park; Elrasheid A H Kheirelseid; Sean M O'Neill; Heron E Rodriguez; Mark D Morasch; Prakash Madhavan; Mark K Eskandari Journal: J Vasc Surg Date: 2012-01-05 Impact factor: 4.268
Authors: Aleksandra C Zoethout; Shirley Ketting; Clark J Zeebregts; Dimitri Apostolou; Barend M E Mees; Patrick Berg; Hazem El Beyrouti; Jean-Paul P M De Vries; Francesco Torella; Mattia Migliari; Roberto Silingardi; Michel M P J Reijnen Journal: J Endovasc Ther Date: 2021-08-03 Impact factor: 3.487