Clinical significance of type I endoleak on completion angiography.
10.4174/astr.2014.86.2.95
- Author:
Suh Min KIM
1
;
Hwan Do RA
;
Sang Il MIN
;
Hwan Jun JAE
;
Jongwon HA
;
Seung Kee MIN
Author Information
1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. skminmd@snuh.org
- Publication Type:Original Article
- Keywords:
Endovascular aneurysm repair;
Abdominal aortic aneurysm;
Endoleak
- MeSH:
Angiography*;
Aortic Aneurysm, Abdominal;
Diagnosis;
Embolization, Therapeutic;
Endoleak*;
Follow-Up Studies;
Fungi;
Humans;
Recurrence;
Retrospective Studies;
Rupture
- From:Annals of Surgical Treatment and Research
2014;86(2):95-99
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Type I endoleak is known to be associated with sac enlargement and occasional rupture, therefore, the treatment of type I endoleak is recommended at the time of diagnosis. The aim of this study was to identify the significance of early type I endoleak found on completion angiography. METHODS: Between January 2000 and December 2012, a total of 86 patients underwent endovascular abdominal aortic aneurysm repair (EVAR) and 10 patients (11.6%) were diagnosed with type Ia endoleak on completion angiography. Clinical and radiologic data were reviewed retrospectively. RESULTS: Of the 10 patients, two underwent EVAR with custom-made stent-grafts in the initial stage and both of them needed immediate treatment: one case involved open repair while the other involved insertion of an additional stent-graft. In 8 patients, the amount of leakage decreased after repeated balloon molding. They were managed conservatively and followed up with computed tomography angiography within 2 weeks after EVAR. In 7 of the 8 cases, type Ia endoleaks disappeared. In one patient with a persistent endoleak and a folded posterior wall of the stent-graft, coil embolization was performed 1 week after EVAR. With a median follow-up of 12 months (range, 1-61 months), no patients showed recurrence of type I endoleak or sac expansion. CONCLUSION: Type I endoleaks diagnosed on completion angiography sealed spontaneously in 7 of 10 patients (70.0%). In cases of decreased amounts of leakage after balloon molding, simple observation may be an alternative to repetitive procedures. The long-term follow-up of patients with self-sealed type I endoleaks is mandatory.
