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Title: Can Early Computed Tomography Angiography after Endovascular Aortic Aneurysm Repair Predict the Need for Reintervention in Patients with Type II Endoleak?

Abstract

PurposeThis study was designed to identify parameters on CT angiography (CTA) of type II endoleaks following endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), which can be used to predict the subsequent need for reinterventions.MethodsWe retrospectively identified 62 patients with type II endoleak who underwent early CTA in mean 3.7 ± 1.9 days after EVAR. On the basis of follow-up examinations (mean follow-up period 911 days; range, 373–1,987 days), patients were stratified into two groups: those who did (n = 18) and those who did not (n = 44) require reintervention. CTA characteristics, such as AAA, endoleak, as well as nidus dimensions, patency of the inferior mesenteric artery, number of aortic branch vessels, and the pattern of endoleak appearance, were recorded and correlated with the clinical outcome.ResultsUnivariate and receiver operating characteristic curve regression analyses revealed significant differences between the two groups for the endoleak volume (surveillance group: 1391.6 ± 1427.9 mm{sup 3}; reintervention group: 3227.7 ± 2693.8 mm{sup 3}; cutoff value of 2,386 mm{sup 3}; p = 0.002), the endoleak diameter (13.6 ± 4.3 mm compared with 25.9 ± 9.6 mm; cutoff value of 19 mm; p < 0.0001), the number of aortic branch vessels (2.9 ± 1.2 compared with 4.2 ± 1.4 vessels; p = 0.001), as well as a “complex type” endoleak pattern (13.6 %, n = 6 compared with 44.4 %, n = 8; p = 0.02).ConclusionsEarly CTA can predict the future need for reintervention inmore » patients with type II endoleak. Therefore, treatment decision should be based not only on aneurysm enlargement alone but also on other imaging characteristics.« less

Authors:
 [1];  [2]; ; ; ;  [1]; ;  [3];  [1];  [2];  [1]
  1. University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany)
  2. Charité Universitätsmedizin Berlin, Department of Radiology (Germany)
  3. University of Magdeburg, Department of General, Visceral and Vascular Surgery (Germany)
Publication Date:
OSTI Identifier:
22470099
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 38; Journal Issue: 1; Conference: IROS 2015: Interventional Radiological Olbert Symposium, Berlin (Germany), 15-17 Jan 2015; Other Information: Copyright (c) 2015 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; BIOMEDICAL RADIOGRAPHY; COMPARATIVE EVALUATIONS; COMPUTERIZED TOMOGRAPHY; DESIGN; INSPECTION; MEDICAL SURVEILLANCE; MONITORING; NITROGEN 18; PATIENTS; REGRESSION ANALYSIS; SECURITY; WHO

Citation Formats

Dudeck, O., E-mail: oliver.dudeck@med.ovgu.de, Schnapauff, D., Herzog, L., Löwenthal, D., Bulla, K., Bulla, B., Halloul, Z., Meyer, F., Pech, M., Gebauer, B., and Ricke, J.. Can Early Computed Tomography Angiography after Endovascular Aortic Aneurysm Repair Predict the Need for Reintervention in Patients with Type II Endoleak?. United States: N. p., 2015. Web. doi:10.1007/S00270-014-0901-6.
Dudeck, O., E-mail: oliver.dudeck@med.ovgu.de, Schnapauff, D., Herzog, L., Löwenthal, D., Bulla, K., Bulla, B., Halloul, Z., Meyer, F., Pech, M., Gebauer, B., & Ricke, J.. Can Early Computed Tomography Angiography after Endovascular Aortic Aneurysm Repair Predict the Need for Reintervention in Patients with Type II Endoleak?. United States. doi:10.1007/S00270-014-0901-6.
Dudeck, O., E-mail: oliver.dudeck@med.ovgu.de, Schnapauff, D., Herzog, L., Löwenthal, D., Bulla, K., Bulla, B., Halloul, Z., Meyer, F., Pech, M., Gebauer, B., and Ricke, J.. Sun . "Can Early Computed Tomography Angiography after Endovascular Aortic Aneurysm Repair Predict the Need for Reintervention in Patients with Type II Endoleak?". United States. doi:10.1007/S00270-014-0901-6.
@article{osti_22470099,
title = {Can Early Computed Tomography Angiography after Endovascular Aortic Aneurysm Repair Predict the Need for Reintervention in Patients with Type II Endoleak?},
author = {Dudeck, O., E-mail: oliver.dudeck@med.ovgu.de and Schnapauff, D. and Herzog, L. and Löwenthal, D. and Bulla, K. and Bulla, B. and Halloul, Z. and Meyer, F. and Pech, M. and Gebauer, B. and Ricke, J.},
abstractNote = {PurposeThis study was designed to identify parameters on CT angiography (CTA) of type II endoleaks following endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), which can be used to predict the subsequent need for reinterventions.MethodsWe retrospectively identified 62 patients with type II endoleak who underwent early CTA in mean 3.7 ± 1.9 days after EVAR. On the basis of follow-up examinations (mean follow-up period 911 days; range, 373–1,987 days), patients were stratified into two groups: those who did (n = 18) and those who did not (n = 44) require reintervention. CTA characteristics, such as AAA, endoleak, as well as nidus dimensions, patency of the inferior mesenteric artery, number of aortic branch vessels, and the pattern of endoleak appearance, were recorded and correlated with the clinical outcome.ResultsUnivariate and receiver operating characteristic curve regression analyses revealed significant differences between the two groups for the endoleak volume (surveillance group: 1391.6 ± 1427.9 mm{sup 3}; reintervention group: 3227.7 ± 2693.8 mm{sup 3}; cutoff value of 2,386 mm{sup 3}; p = 0.002), the endoleak diameter (13.6 ± 4.3 mm compared with 25.9 ± 9.6 mm; cutoff value of 19 mm; p < 0.0001), the number of aortic branch vessels (2.9 ± 1.2 compared with 4.2 ± 1.4 vessels; p = 0.001), as well as a “complex type” endoleak pattern (13.6 %, n = 6 compared with 44.4 %, n = 8; p = 0.02).ConclusionsEarly CTA can predict the future need for reintervention in patients with type II endoleak. Therefore, treatment decision should be based not only on aneurysm enlargement alone but also on other imaging characteristics.},
doi = {10.1007/S00270-014-0901-6},
journal = {Cardiovascular and Interventional Radiology},
number = 1,
volume = 38,
place = {United States},
year = {Sun Feb 15 00:00:00 EST 2015},
month = {Sun Feb 15 00:00:00 EST 2015}
}