Clinical significance of type II endoleaks after thoracic endovascular aortic repair

• Verfasst von: Bischoff, Moritz [VerfasserIn]
• Verfasst von: Geisbüsch, Philipp [VerfasserIn]
• Verfasst von: Kotelis, Drosos [VerfasserIn]
• Verfasst von: Müller-Eschner, Matthias [VerfasserIn]
• Verfasst von: Hyhlik-Dürr, Alexander [VerfasserIn]
• Verfasst von: Böckler, Dittmar [VerfasserIn]
• Titel: Clinical significance of type II endoleaks after thoracic endovascular aortic repair
• Verf.angabe: Moritz S. Bischoff, MD, Philipp Geisbüsch, MD, Drosos Kotelis, MD, Matthias Müller-Eschner, MD, Alexander Hyhlik-Dürr, MD, and Dittmar Böckler, MD
• E-Jahr: 2013
• Jahr: 14 May 2013
• Umfang: 8 S.
• Fussnoten: Gesehen am 26.11.2020
• Titel Quelle: Enthalten in: Journal of vascular surgery
• Ort Quelle: Amsterdam [u.a.] : Elsevier, 1984
• Jahr Quelle: 2013
• Band/Heft Quelle: 58(2013), 3, Seite 643-650
• ISSN Quelle: 1097-6809
• DOI: doi:10.1016/j.jvs.2013.03.026
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1741197112

Abstract

Background - To evaluate the clinical significance of type II endoleaks (ELII) after thoracic endovascular aortic repair (TEVAR). - Methods - From January 1997 to June 2012, a total of 344 patients received TEVAR in our institution. ELII was diagnosed in 30 patients (8.7%; 13 males; median age: 65 years, range: 24 to 84 years), representing the study population of this retrospective, single-center analysis. Mean follow-up was 29.5 months (range, 8 months to 9.5 years). - Results - Primary ELII was observed in all but two cases (28/30; 93.3%). The most common sources of ELII were the left subclavian artery (LSA; 13/30; 43.3%) and intercostal/bronchial vessels (13/30; 43.3%), followed by visceral arteries (4/30; 13.4%). Overall mortality was 33.3% (10/30). ELII-related death (secondary rupture) was observed in 20% (2/10). Reintervention (RI) procedures for ELII were performed in 9 of 30 patients (30.0%); 5 of 9 (55.6%) in cases with ELII via the LSA. Indications for RI were diameter expansion in five and extensive leakage in four cases. Treatment was successful in five patients (55.6%) but failed in four cases (44.4%). In 12 of 21 (57.1%) untreated patients, ELII sealed during follow-up. In conservatively treated patients, an increase in aortic diameter has been only observed in a patient with secondary ELII. - Conclusions - The results presented herein suggest that the clinical impact of ELII after TEVAR must not be underestimated. Albeit a transient finding in most cases, ELII is associated with a relevant RI rate, particularly in cases involving the LSA. RI seems indicated in patients with increasing aortic diameter and/or extensive leakage. Careful surveillance of all patients with ELII is recommended.