Long-term clinical outcomes of type 2 endoleak intervention and the crucial role of additional endoleak development after endovascular aneurysm repair:a single-center retrospective observational cohort study
10.4174/astr.2025.109.4.235
- Author:
Sang Ah LEE
1
;
Tae-Won KWON
;
Yong-Pil CHO
;
Jun Gyo GWON
;
Youngjin HAN
Author Information
1. Division of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Annals of Surgical Treatment and Research
2025;109(4):235-243
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:The primary objective of this study was to evaluate long-term outcomes in patients who underwent endovascular treatments for type II endoleaks (T2ELs) following endovascular aneurysm repair (EVAR).
Methods:This single-center, retrospective study included patients who developed early T2EL after EVAR for abdominal aortic aneurysm. Patients were divided into those who did and did not receive intervention for T2EL. Study outcomes included 10-year overall survival (OS), open conversion-free survival, and T2EL regression rates without open conversion.
Results:Of the 385 patients who underwent EVAR between January 2006 and December 2016, 65 (16.9%) had early T2EL.Of these, 22 (33.8%) underwent T2EL intervention and 43 (66.2%) were treated conservatively. Eight (12.3%) of the 65 patients required open conversion, with no significant difference in open conversion-free survival between the two groups (P = 0.080). T2EL regression occurred in 16 of 62 patients (25.8%), with no difference in T2EL closure rates between the groups (P = 0.755). Analysis of the 31 patients with sac growth showed no significant between-group differences in 10-year OS, open conversion-free survival, and T2EL regression rates, regardless of T2EL intervention. Cox regression analysis identified that the development of other types of endoleak was the only risk factor for open conversion.
Conclusion:Interventions for T2EL did not improve OS rates, reduce open conversion rates, or increase T2EL closure rates, even in patients with sac growth. This study suggests that current T2EL interventions are not sufficiently effective, emphasizing the need to detect the development of other types of endoleak that may lead to rupture.
