Embolization of type II endoleaks is successful early in preventing aneurysm sac growth and rupture after EVAR. However, a significant number of patients require more than one procedure, and at 5 years, many patients who underwent embolization of a type II endoleak continued to experience sac growth. Patients with hyperlipidemia who undergo coil embolization are more likely to require a second embolization procedure, and patients who smoke have a higher likelihood of AAA sac expansion after embolization. Continued long-term surveillance is necessary in this cohort of patients.

in the study. Main outcomes were mortality, complications, reinterventions, and length of hospital stay.Results: Fifty-eight patients (mean age 71 years (range 49-87), 53 (91%) males) with a total of 80 aortic and/or iliac pseudo or true PAA were treated with an endovascular stentgraft. Devices that were used were tube grafts (n ϭ 8), bifurcated stentgrafts (n ϭ 32), aorto-uni-iliac stentgrafts (n ϭ 7), and iliac extension grafts (n ϭ 11). Technical success rate was 95%. Median hospital stay was 3 days (range 1-122). The 30-day mortality rate was 3.4% (n ϭ 2). Mean follow-up was 41 months (range 0-106). Procedure related and cumulative mortality rate was 10% (n ϭ 6) and 19% (n ϭ 11), respectively. CTA revealed 9 endoleaks (3 type I and 6 type II) in 8 patients and endotension in 2 patients. Type I endoleaks were observed in 25% of patients treated with endovascular tube grafts. The overall reintervention rate was 19% (n ϭ 11) with an annual risk of 4.7%. In non-tube graft patients the annual risk was 4.0%.Conclusions: The present study shows that endovascular repair with bifurcated or aorto-uni-iliac stentgrafts of paraanastomotic aortic and iliac aneurysms after initial prosthetic aortic surgery is a durable alternative to open reconstruction.