Predictive Factors, Morphologic Effects, and Proposed Treatment Paradigm for Type II Endoleaks after Repair of Infrarenal Abdominal Aortic Aneurysms

Identification of Predictive CT Angiographic Factors in the Development of High-Risk Type 2 Endoleaks after Endovascular Aneurysm Repair in Patients with Infrarenal Aortic Aneurysms

“…These results corresponded with those of other authors [6,18,28,29]. Therefore, Higashura et al were able to show in a prospective study on the basis of 273 patients that both the diameter of the AAA with an average of 56 mm (range: 40 -93 mm) and the length of the aneurysm neck have no relevant effect on the development of a persistent type 2 endoleak [28]. In summary, no morphological parameter of the AAA proved suitable in this study as a predictive factor for the development of a type 2 endoleak in the HRG.…”

“…Additional morphological parameters, such as the length, diameter, and surface area of the AAA and of the perfused aneurysm lumen, did not differ between the two groups. These results corresponded with those of other authors [6,18,28,29]. Therefore, Higashura et al were able to show in a prospective study on the basis of 273 patients that both the diameter of the AAA with an average of 56 mm (range: 40 -93 mm) and the length of the aneurysm neck have no relevant effect on the development of a persistent type 2 endoleak [28].…”

Outcomes of percutaneous endovascular intervention for type II endoleak with aneurysm expansion

“…The necessity, optimal timing, and most efficacious type of secondary intervention for type II endoleak (T2EL) have generated greater controversy, although it is widely accepted that intervention is unnecessary if the aneurysm sac size remains stable or diminishes. [6][7][8] As the natural history of T2EL is not fully understood, proposed treatment algorithms are in part based upon anecdotal experience 9 or outcomes of retrospective studies evaluating all patients diagnosed with T2EL, rather than those patients with accompanying sac enlargement. [6][7][8]10 Specifically, these reports promote the selective use of angiographic modalities to treat T2EL but do not detail mid-and long-term outcomes of these interventions.…”

“…[6][7][8] As the natural history of T2EL is not fully understood, proposed treatment algorithms are in part based upon anecdotal experience 9 or outcomes of retrospective studies evaluating all patients diagnosed with T2EL, rather than those patients with accompanying sac enlargement. [6][7][8]10 Specifically, these reports promote the selective use of angiographic modalities to treat T2EL but do not detail mid-and long-term outcomes of these interventions. Such information is necessary to define whether these treatments offer complete or partial success in halting aneurysm sac growth and preventing rupture.…”

The Influence of Preoperative Aneurysmal Thrombus Quantity and Distribution on the Development of Type II Endoleaks with Aneurysm Sac Enlargement After EVAR of AAA

“…Possible sources (feeding and/or draining vessels) of type II endoleaks are the inferior mesenteric artery, lumbar arteries, median sacral artery, or accessory renal arteries. Persistent type II endoleaks ([6 months after EVAR) are associated with aneurysm sac enlargement and stent-graft migration, and may cause rupture of the aneurysm sac [4,5]. Type II endoleaks without aneurysm sac enlargement can be observed.…”