Martijn L Dijkstra1, Clark J Zeebregts2, Hence J M Verhagen3, Joep A W Teijink4, Adam H Power5, Dittmar Bockler6, Patrick Peeters7, Vicente Riambau8, Jean-Pierre Becquemin9, Michel M P J Reijnen10. 1. the Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands; the Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: martijn.dijkstra@gmail.com. 2. the Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 3. the Division of Vascular Surgery, Department of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands. 4. the Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands. 5. the Division of Vascular Surgery, Western University, London, Ontario, Canada. 6. the Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Heidelberg, Germany. 7. the Department of Cardiovascular Surgery, Imelda Hospital, Bonheiden, Belgium. 8. the Division of Vascular Surgery, Cardiovascular Institute, Hospital Clinic of Barcelona, Barcelona, Spain. 9. Department of Vascular Surgery, Henri Mondor Hospital, Créteil, France. 10. the Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands; Multimodality Imaging Group, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands.
Abstract
OBJECTIVE: The purpose of this study was to report the incidence, natural history, and outcome of type II endoleaks in the largest prospective real-world cohort to date. METHODS: Patients were extracted from the prospective Endurant Stent Graft Natural Selection Global Postmarket Registry (ENGAGE). Two groups were analyzed: first, patients with an isolated type II endoleak; and second, patients with a type II endoleak who later presented with a type I endoleak. A health status analysis between patients with an early type II endoleak and patients with no endoleak was performed. Second, an attempt was made to identify risk factors in patients with a type II endoleak who later presented with a type I endoleak. RESULTS: Through 5 years of follow-up, a total of 197 (15.6%) patients with isolated type II endoleaks were identified. Most were detected within the first 30 days (n = 73 [37.1%]) and through the first year (n = 73 [37.1%]), with the remainder being detected after 1 year of follow-up (n = 51 [25.8%]). Patients with a type II endoleak had a higher incidence of aneurysm growth and more secondary endovascular procedures (15.4% vs 7.5% at 5 years; P < .001). Overall survival was higher in the isolated type II endoleak group compared with patients with no endoleak (77.2% vs 67.0% at 5 years; P = .010). Twenty-two patients (10%) with a type II endoleak were diagnosed with a late type I endoleak (type IA, n = 10; type IB, n = 12), with a secondary intervention rate of 67.5% through 5 years. There was no difference in health status scores between patients with an early type II endoleak and patients without any type of endoleak at 1-year follow-up. CONCLUSIONS: In the ENGAGE registry, isolated type II endoleaks are present in 15.6% of patients during follow-up. The majority do not require secondary intervention, and an early isolated type II endoleak does not have an impact on health status through 1 year. However, a small group of patients with a type II endoleak will present with a type I endoleak, resulting in a high secondary intervention rate and significant risk of aneurysm-related complications.
OBJECTIVE: The purpose of this study was to report the incidence, natural history, and outcome of type II endoleaks in the largest prospective real-world cohort to date. METHODS:Patients were extracted from the prospective Endurant Stent Graft Natural Selection Global Postmarket Registry (ENGAGE). Two groups were analyzed: first, patients with an isolated type II endoleak; and second, patients with a type II endoleak who later presented with a type I endoleak. A health status analysis between patients with an early type II endoleak and patients with no endoleak was performed. Second, an attempt was made to identify risk factors in patients with a type II endoleak who later presented with a type I endoleak. RESULTS: Through 5 years of follow-up, a total of 197 (15.6%) patients with isolated type II endoleaks were identified. Most were detected within the first 30 days (n = 73 [37.1%]) and through the first year (n = 73 [37.1%]), with the remainder being detected after 1 year of follow-up (n = 51 [25.8%]). Patients with a type II endoleak had a higher incidence of aneurysm growth and more secondary endovascular procedures (15.4% vs 7.5% at 5 years; P < .001). Overall survival was higher in the isolated type II endoleak group compared with patients with no endoleak (77.2% vs 67.0% at 5 years; P = .010). Twenty-two patients (10%) with a type II endoleak were diagnosed with a late type I endoleak (type IA, n = 10; type IB, n = 12), with a secondary intervention rate of 67.5% through 5 years. There was no difference in health status scores between patients with an early type II endoleak and patients without any type of endoleak at 1-year follow-up. CONCLUSIONS: In the ENGAGE registry, isolated type II endoleaks are present in 15.6% of patients during follow-up. The majority do not require secondary intervention, and an early isolated type II endoleak does not have an impact on health status through 1 year. However, a small group of patients with a type II endoleak will present with a type I endoleak, resulting in a high secondary intervention rate and significant risk of aneurysm-related complications.
Authors: Rianne E van Rijswijk; Erik Groot Jebbink; Suzanne Holewijn; Nicky Stoop; Steven M van Sterkenburg; Michel M P J Reijnen Journal: J Clin Med Date: 2022-03-03 Impact factor: 4.241
Authors: Aleksandra C Zoethout; Iris Hochstenbach; Maarten J van der Laan; Jean-Paul P M de Vries; Michel M P J Reijnen; Clark J Zeebregts Journal: J Endovasc Ther Date: 2021-09-27 Impact factor: 3.089
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