For a study, researchers examined the outcomes of endovascular aneurysm repair in patients from the Committee for Stentgraft Management registry to assess the importance of persistent type II endoleak (p-T2EL) and the risk of late adverse events, such as aneurysm sac expansion. From 2006 to 2015, the medical records of 17,099 patients <75 years of age who underwent endovascular aneurysm repair for abdominal aortic aneurysm were examined. Patients were separated into two groups (with and without p-T2EL) and compared to see if there was a link between p-T2EL and aneurysm sac expansion following endovascular aneurysm repair.
About 4,957 individuals (29.0%) had p-T2EL, whereas 12,142 (71.0%) did not (non-T2EL). The p-T2EL group had a substantially greater mean age (P<0.001) and fewer men (P<0.001). Among comorbidities, hypertension (P=0.019) and chronic renal disease (P=0.040) were more common in the p-T2EL group, but respiratory diseases were less common (P<0.001). To account for disparities in patient characteristics, 4,957 patients from each group were matched according to propensity score. The cumulative incidence rates of abdominal aortic aneurysm–related mortality (p-T2EL: 52 of 4,957 [1.0%] versus non-T2EL: 21 of 12 142 [0.2%]), rupture (p-T2EL: 38 of 4,957 [0.8%] versus non-T2EL: 13 of 12 142 [0.1%]), sac enlargement (≥5 mm; p-T2EL: 1359 of 4957 [27.4%] versus non-T2EL: 332 of 12,142 [2.7%]), and reintervention (p-T2EL: 739 of 4,957 [14.9%] versus non-T2EL: 91 of 12,142 [0.7%]) were significantly higher in the p-T2EL than the nonpT2EL group (P<0.001). Propensity score matching resulted in a greater projected incremental risk for abdominal aortic aneurysm–related death, rupture, sac expansion (≥5 mm), and p-T2EL reintervention (P<0.001). Cox regression analysis indicated that older age (P=0.010), proximal neck diameter (P=0.003), and chronic renal illness (P<0.001) were independent positive predictors of sac enlargement, whereas male sex was an independent negative predictor (P=0.015).
The Committee for Stentgraft Management registry data demonstrated a link between p-T2EL and late adverse outcomes following endovascular aneurysm repair, such as aneurysm sac expansion, reintervention, rupture, and abdominal aortic aneurysm–related death. Aside from p-T2EL, sac enlargement was linked with older age, female sex, chronic renal illness, and a dilated proximal neck.
Reference:www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.056581
