Gray, D., Shahverdyan, R., Reifferscheid, V., Gawenda, M. and Brunkwall, J. S. (2017). EVAR with Flared Iliac Limbs has a High Risk of Late Type 1b Endoleak. Eur. J. Vasc. Endovasc. Surg., 54 (2). S. 170 - 177. LONDON: W B SAUNDERS CO LTD. ISSN 1532-2165
Full text not available from this repository.Abstract
Introduction: Re-interventions are still the Achilles' heel of endovascular aneurysm repair (EVAR). Ectatic common iliac arteries (CIA) can be treated with flared iliac limbs but a dilated artery used as sealing zone could increase the risk of a late type 1b endoleak. The aim of the present analysis was to evaluate the risk of late type 1b endoleak after EVAR in patients with CIA limbs >= 20 mm compared with those <20 mm. Methods: A retrospective analysis was performed of patients treated by EVAR at the study institution between 2006 and 2012, including patients with available information about the type of iliac stent grafts and a minimum follow-up (FU) of 3 years with contrast enhanced CT, or those that had developed a type 1b endoleak earlier. The cohort was divided into two groups: Group I included iliac limbs with a distal diameter <20 mm, and Group II included all iliac limbs with a distal diameter >= 20 mm. Results: Of 692 limbs (346 patients),239 limbs (34.5%) from 129 patients were included in the analysis. Mean CT FU was 53 months, 178 had an iliac stent graft diameter <20 mm (Group I), and 61 a diameter of >= 20 mm (Group II). Mean oversizing for iliac limbs was 17.2% (IQR 14) and there was no case of immediate type lb endoleak. For the whole group, 18 type 1b endoleaks occurred during FU (7.5%) after a mean of 37.7 months (range 4-96). Eleven of 61 (18%) iliac limbs in Group II developed a type lb endoleak during FU in contrast to 7/178 (3.9%) in Group I (OR 5.3, 95% CI 1.98-14.59, p = 0,001). The ROC curve analysis indicated a limb diameter of 19 mm as a cutoff value for a higher probability of developing a type 1b endoleak. Conclusion: Patients treated with iliac limbs >= 20 mm had a fivefold higher risk of late (mean 37 months) type lb endoleak compared with patients treated with a distal iliac limb diameter <20 mm. (C) 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Item Type: | Journal Article | ||||||||||||||||||||||||
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URN: | urn:nbn:de:hbz:38-224030 | ||||||||||||||||||||||||
DOI: | 10.1016/j.ejvs.2017.05.008 | ||||||||||||||||||||||||
Journal or Publication Title: | Eur. J. Vasc. Endovasc. Surg. | ||||||||||||||||||||||||
Volume: | 54 | ||||||||||||||||||||||||
Number: | 2 | ||||||||||||||||||||||||
Page Range: | S. 170 - 177 | ||||||||||||||||||||||||
Date: | 2017 | ||||||||||||||||||||||||
Publisher: | W B SAUNDERS CO LTD | ||||||||||||||||||||||||
Place of Publication: | LONDON | ||||||||||||||||||||||||
ISSN: | 1532-2165 | ||||||||||||||||||||||||
Language: | English | ||||||||||||||||||||||||
Faculty: | Unspecified | ||||||||||||||||||||||||
Divisions: | Unspecified | ||||||||||||||||||||||||
Subjects: | no entry | ||||||||||||||||||||||||
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Refereed: | Yes | ||||||||||||||||||||||||
URI: | http://kups.ub.uni-koeln.de/id/eprint/22403 |
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