IMPACT OF TYPE-II ENDOLEAK ON ANEURYSM SAC IN A SINGLE CENTER
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48750/acv.115 |
Resumo: | Objective: Type 2 endoleak occurs in up to 30% of endovascular aneurysm repair (EVAR), but its long-term significance continues to be one of the most controversial topics. We reviewed our experience to evaluate late outcomes associated with type 2 endoleak. Methods: Between January 2008 to December 2014, 57 patients undergoing EVAR were enrolled in the presenting study. Computed tomography (angioCT) scan assessment was performed to evaluate aneurysm sac evolution. Primary end points included type 2 endoleak incidence, aneurysm sac growth, abdominal aortic aneurysm (AAA) related rupture and death. Secondary endpoints included conversion to open repair, reintervention rate, type 2 endoleak persistence and failure to shrinkage > 5mm and abdominal aortic aneurysm (AAA) rupture. Results: We identified 10 (17.5%) patients with type 2 endoleaks (6 early at the first follow-up CT scan). Median followup was 39.0 ± 31,6 months. Endoleaks persisted in 7 patients (12,2% of total patients; 70,0% of type 2 endoleaks) for >6 months. Overall survival rate was 100%, 98% and 80% at 1, 2 and 5 years. Spontaneous sealing occurred in 6/10 (60%): 3/3 (100.0%) transient type 2 endoleaks and 3/7 (43%) persistent type 2 endoleak. Transient type 2 endoleak (those that resolved <6 months of EVAR) weren´t associated with adverse late outcomes. In contrast, persistent endoleak was associated with several adverse outcomes. When evaluating patients with transitory endoleak vs persistent endoleak, freedom from sac expansion at 1, 3, and 5 years was 100% (transitory) vs 85%, 65%, e 40% (persistent) (P < .001). Patients with persistent endoleak were at increased risk for aneurysm sac growth vs patients without endoleak (odds ratio [OR], 36.0; 95% confidence interval [CI] 2,15 - 79; P < .02). The only reintervention occurred in a persistent endoleak). There was no aneurysm rupture or AAA-related death. Conclusion: Small sample size have limited this study ability to evaluate the impact on endoleak on adverse outcomes. Persistent type II endoleaks led to significant aneurysm sac enlargement, but without increased mortality or rupture rate. |
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IMPACT OF TYPE-II ENDOLEAK ON ANEURYSM SAC IN A SINGLE CENTERIMPACTO DO ENDOLEAK TIPO 2 NO SACO ANEURISMÁTICO: ANÁLISE UNICÊNTRICAAneurisma da aorta abdominalEndoleakEstudo de follow-upProcedimento endovascularResultado do tratamentoRe-operaçãoAbdominal aortic aneurysmEndoleakEndovascular repairFollow-up studyRe-operationTreatment outcomeObjective: Type 2 endoleak occurs in up to 30% of endovascular aneurysm repair (EVAR), but its long-term significance continues to be one of the most controversial topics. We reviewed our experience to evaluate late outcomes associated with type 2 endoleak. Methods: Between January 2008 to December 2014, 57 patients undergoing EVAR were enrolled in the presenting study. Computed tomography (angioCT) scan assessment was performed to evaluate aneurysm sac evolution. Primary end points included type 2 endoleak incidence, aneurysm sac growth, abdominal aortic aneurysm (AAA) related rupture and death. Secondary endpoints included conversion to open repair, reintervention rate, type 2 endoleak persistence and failure to shrinkage > 5mm and abdominal aortic aneurysm (AAA) rupture. Results: We identified 10 (17.5%) patients with type 2 endoleaks (6 early at the first follow-up CT scan). Median followup was 39.0 ± 31,6 months. Endoleaks persisted in 7 patients (12,2% of total patients; 70,0% of type 2 endoleaks) for >6 months. Overall survival rate was 100%, 98% and 80% at 1, 2 and 5 years. Spontaneous sealing occurred in 6/10 (60%): 3/3 (100.0%) transient type 2 endoleaks and 3/7 (43%) persistent type 2 endoleak. Transient type 2 endoleak (those that resolved <6 months of EVAR) weren´t associated with adverse late outcomes. In contrast, persistent endoleak was associated with several adverse outcomes. When evaluating patients with transitory endoleak vs persistent endoleak, freedom from sac expansion at 1, 3, and 5 years was 100% (transitory) vs 85%, 65%, e 40% (persistent) (P < .001). Patients with persistent endoleak were at increased risk for aneurysm sac growth vs patients without endoleak (odds ratio [OR], 36.0; 95% confidence interval [CI] 2,15 - 79; P < .02). The only reintervention occurred in a persistent endoleak). There was no aneurysm rupture or AAA-related death. Conclusion: Small sample size have limited this study ability to evaluate the impact on endoleak on adverse outcomes. Persistent type II endoleaks led to significant aneurysm sac enlargement, but without increased mortality or rupture rate.Objetivo: A incidência de endoleak tipo 2 após correção endovascular do aneurisma da aorta abdominal (EVAR) pode atingir os 30%, mas o seu significado a longo prazo continua a ser um dos temas mais controversos. Revimos a nossa série com o objetivo de avaliar a incidência de endoleak tipo 2 e os eventos adversos a ele associados. Métodos : Durante o período de janeiro de 2008 a dezembro de 2014, 57 doentes submetidos a EVAR foram considerados elegíveis para o estudo. Para o efeito efetuou-se uma análise da tomografia computadorizada (angioTC) obtida no decurso do seguimento. Os objetivos primários do estudo consistiram na determinação da incidência de endoleak tipo 2, crescimento do saco aneurismático, rutura e morte relacionada com o aneurisma da aorta abdominal (AAA). Adicionalmente estabeleceram-se como objectivos secundários a determinação da taxa de conversão para cirurgia clássica e das taxas de reintervenção associados com a resolução de endoleaks, persistência do EL-T-II e falência de shrinkage do saco aneurismático > 5 mm. Resultados: Foram identificados 10 (17,5%) casos de endoleak tipo 2 (6 precoces no primeiro seguimento por TC). A mediana do seguimento foi de 39,0 ± 31,6 meses. Foram identificados 7 endoleaks persistentes (12,2% do total de EVARs; 70,0% dos endoleaks tipo 2) para > 6 meses. A selagem espontânea ocorreu em 6/10 (60%): 3/3 (100,0%) endoleaks transitórios e 3/7 (43%) dos endoleaks persistentes. O desenvolvimento de endoleak tipo 2 transitório (resolução < 6 meses após EVAR) não esteve associado a resultados tardios adversos, contrariamente ao endoleak persistente. Na comparação entre endoleak transitório vs persistente, a ausência de expansão do saco aos 1, 3 e 5 anos foi de 100% para o grupo transitório vs 85%, 65% e 40% para o grupo persistente (p<.001). A presença de endoleak persistente conferiu maior risco de crescimento do saco vs ausência de endoleak (odds ratio [OR], 36,0; 95% intervalo de confiança [IC]: 2,15 - 79; p <0,02). A única reintervenção ocorreu num endoleak persistente. Não houve rutura ou morte relacionada com o AAA. Conclusão: O pequeno número de casos limitou a capacidade para o presente estudo avaliar o impacto do endoleak. O endoleaks tipo II persistente associou-se de forma significativa a crescimento do saco aneurismático e reintervenção, mas não se associação a mortalidade ou rutura.Sociedade Portuguesa de Angiologia e Cirurgia Vascular2017-11-14T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48750/acv.115oai:ojs.acvjournal.com:article/115Angiologia e Cirurgia Vascular; Vol. 13 No. 2 (2017): June; 26-34Angiologia e Cirurgia Vascular; Vol. 13 N.º 2 (2017): Junho; 26-342183-00961646-706Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://acvjournal.com/index.php/acv/article/view/115https://doi.org/10.48750/acv.115http://acvjournal.com/index.php/acv/article/view/115/23Copyright (c) 2017 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessVarino, JulianaVale Pereira, RicardoMendes, CarolinaMarinho, AndréRodrigues, RogerGonçalves, AnabelaAntunes, LuísMarques, MargaridaMatos, Albuquerque2022-05-23T15:10:02Zoai:ojs.acvjournal.com:article/115Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T14:57:30.871449Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
IMPACT OF TYPE-II ENDOLEAK ON ANEURYSM SAC IN A SINGLE CENTER IMPACTO DO ENDOLEAK TIPO 2 NO SACO ANEURISMÁTICO: ANÁLISE UNICÊNTRICA |
title |
IMPACT OF TYPE-II ENDOLEAK ON ANEURYSM SAC IN A SINGLE CENTER |
spellingShingle |
IMPACT OF TYPE-II ENDOLEAK ON ANEURYSM SAC IN A SINGLE CENTER Varino, Juliana Aneurisma da aorta abdominal Endoleak Estudo de follow-up Procedimento endovascular Resultado do tratamento Re-operação Abdominal aortic aneurysm Endoleak Endovascular repair Follow-up study Re-operation Treatment outcome |
title_short |
IMPACT OF TYPE-II ENDOLEAK ON ANEURYSM SAC IN A SINGLE CENTER |
title_full |
IMPACT OF TYPE-II ENDOLEAK ON ANEURYSM SAC IN A SINGLE CENTER |
title_fullStr |
IMPACT OF TYPE-II ENDOLEAK ON ANEURYSM SAC IN A SINGLE CENTER |
title_full_unstemmed |
IMPACT OF TYPE-II ENDOLEAK ON ANEURYSM SAC IN A SINGLE CENTER |
title_sort |
IMPACT OF TYPE-II ENDOLEAK ON ANEURYSM SAC IN A SINGLE CENTER |
author |
Varino, Juliana |
author_facet |
Varino, Juliana Vale Pereira, Ricardo Mendes, Carolina Marinho, André Rodrigues, Roger Gonçalves, Anabela Antunes, Luís Marques, Margarida Matos, Albuquerque |
author_role |
author |
author2 |
Vale Pereira, Ricardo Mendes, Carolina Marinho, André Rodrigues, Roger Gonçalves, Anabela Antunes, Luís Marques, Margarida Matos, Albuquerque |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Varino, Juliana Vale Pereira, Ricardo Mendes, Carolina Marinho, André Rodrigues, Roger Gonçalves, Anabela Antunes, Luís Marques, Margarida Matos, Albuquerque |
dc.subject.por.fl_str_mv |
Aneurisma da aorta abdominal Endoleak Estudo de follow-up Procedimento endovascular Resultado do tratamento Re-operação Abdominal aortic aneurysm Endoleak Endovascular repair Follow-up study Re-operation Treatment outcome |
topic |
Aneurisma da aorta abdominal Endoleak Estudo de follow-up Procedimento endovascular Resultado do tratamento Re-operação Abdominal aortic aneurysm Endoleak Endovascular repair Follow-up study Re-operation Treatment outcome |
description |
Objective: Type 2 endoleak occurs in up to 30% of endovascular aneurysm repair (EVAR), but its long-term significance continues to be one of the most controversial topics. We reviewed our experience to evaluate late outcomes associated with type 2 endoleak. Methods: Between January 2008 to December 2014, 57 patients undergoing EVAR were enrolled in the presenting study. Computed tomography (angioCT) scan assessment was performed to evaluate aneurysm sac evolution. Primary end points included type 2 endoleak incidence, aneurysm sac growth, abdominal aortic aneurysm (AAA) related rupture and death. Secondary endpoints included conversion to open repair, reintervention rate, type 2 endoleak persistence and failure to shrinkage > 5mm and abdominal aortic aneurysm (AAA) rupture. Results: We identified 10 (17.5%) patients with type 2 endoleaks (6 early at the first follow-up CT scan). Median followup was 39.0 ± 31,6 months. Endoleaks persisted in 7 patients (12,2% of total patients; 70,0% of type 2 endoleaks) for >6 months. Overall survival rate was 100%, 98% and 80% at 1, 2 and 5 years. Spontaneous sealing occurred in 6/10 (60%): 3/3 (100.0%) transient type 2 endoleaks and 3/7 (43%) persistent type 2 endoleak. Transient type 2 endoleak (those that resolved <6 months of EVAR) weren´t associated with adverse late outcomes. In contrast, persistent endoleak was associated with several adverse outcomes. When evaluating patients with transitory endoleak vs persistent endoleak, freedom from sac expansion at 1, 3, and 5 years was 100% (transitory) vs 85%, 65%, e 40% (persistent) (P < .001). Patients with persistent endoleak were at increased risk for aneurysm sac growth vs patients without endoleak (odds ratio [OR], 36.0; 95% confidence interval [CI] 2,15 - 79; P < .02). The only reintervention occurred in a persistent endoleak). There was no aneurysm rupture or AAA-related death. Conclusion: Small sample size have limited this study ability to evaluate the impact on endoleak on adverse outcomes. Persistent type II endoleaks led to significant aneurysm sac enlargement, but without increased mortality or rupture rate. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-11-14T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.48750/acv.115 oai:ojs.acvjournal.com:article/115 |
url |
https://doi.org/10.48750/acv.115 |
identifier_str_mv |
oai:ojs.acvjournal.com:article/115 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://acvjournal.com/index.php/acv/article/view/115 https://doi.org/10.48750/acv.115 http://acvjournal.com/index.php/acv/article/view/115/23 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Angiologia e Cirurgia Vascular info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Angiologia e Cirurgia Vascular |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
dc.source.none.fl_str_mv |
Angiologia e Cirurgia Vascular; Vol. 13 No. 2 (2017): June; 26-34 Angiologia e Cirurgia Vascular; Vol. 13 N.º 2 (2017): Junho; 26-34 2183-0096 1646-706X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799129848734547968 |