Clinical significance of endoleaks characterized by computed tomography during aortography performed immediately after endovascular abdominal aortic aneurysm repair: prediction of persistent endoleak.

Abstract

PURPOSE:

This study aimed to predict the persistence of endoleaks (ELs) using patterns and volumes evaluated by computed tomography during aortography (CTDA) performed immediately after endovascular abdominal aortic aneurysm repair (EVAR).

MATERIALS AND METHODS:

CTDA immediately after EVAR and at the 6-month follow-up CT were performed in 52 patients. ELs were classified as localized-type pattern (LTP; <180° around the center of the aneurysmal lumen) or circumferential-type pattern (CTP; >180°). The proportion of EL volume in the aneurysmal sac, excluding mural thrombus, was classified as grade A (≤5 %), B (5-10 %), or C (≥10 %). The 6-month follow-up residual rates were evaluated, and volume ratios (follow-up CT aneurysmal volume including mural thrombus/CTDA aneurysmal volume) were calculated.

RESULTS:

The residual rate (5.3 %) and mean volume ratio (83.9 %) of ELs with LTP were significantly lower than those of ELs with CTP (72.2 and 99.3 %, respectively); there was no significant difference in residual rate or mean volume ratio among EL grades (A: 17.6, 88.1 %; B: 55.6, 89.7 %; C: 54.5, 97.8 %).

CONCLUSION:

ELs with LTP generally disappear over time after EVAR, with a concomitant reduction in aneurysm volume, whereas those with CTP persist, indicating that patients with EL with a CTP should be followed up carefully.

• Authors: Motoki Nakai, Hirotatsu Sato, Morio Sato, Yuko Tanba, Yasutaka Noda, Akira Ikoma, Hiroki Sanda, Kohei Nakata, Hiroki Minamiguchi, Nobuyuki Kawai, Tetsuo Sonomura, Kazushi Kishi, Yosiharu Nishimura, Yoshitaka Okamura
• Journal: Japanese journal of radiology (Jpn J Radiol) Vol. 31 Issue 1 Pg. 16-23 (Jan 2013) ISSN: 1867-108X [Electronic] Japan
• PMID: 23054884 (Publication Type: Journal Article)

Chemical References

• Contrast Media
• Iopamidol

Topics

• Aged
• Aged, 80 and over
• Aortic Aneurysm, Abdominal (diagnostic imaging, surgery)
• Aortography (methods)
• Blood Vessel Prosthesis
• Blood Vessel Prosthesis Implantation (methods)
• Contrast Media
• Endoleak
• Female
• Humans
• Iopamidol
• Male
• Middle Aged
• Postoperative Complications (diagnostic imaging)
• Predictive Value of Tests
• Statistics, Nonparametric
• Tomography, X-Ray Computed (methods)