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. 2020 Sep 25;13(3):261-268.
doi: 10.3400/avd.oa.20-00057.

Preoperative Neck Angulation is Associated with Aneurysm Sac Growth Due to Persistent Type Ia Endoleak after Endovascular Abdominal Aortic Aneurysm Repair

Yoshimasa Seike  1 , Tetsuya Fukuda  2 , Koki Yokawa  1 , Yosuke Inoue  1 , Takayuki Shijo  1 , Kyokun Uehara  1 , Hiroaki Sasaki  1 , Hitoshi Matsuda  1
Affiliations

Preoperative Neck Angulation is Associated with Aneurysm Sac Growth Due to Persistent Type Ia Endoleak after Endovascular Abdominal Aortic Aneurysm Repair

Yoshimasa Seike et al. Ann Vasc Dis. .

Abstract

Objective: This study aims to determine how instructions for use affect the occurrence of aneurysm sac growth and endoleaks after an endovascular aneurysm repair (EVAR). Materials and Methods: We reviewed 302 patients who underwent EVAR for abdominal aortic aneurysm between 2007 and 2013, and we were able to enroll 159 patients (74% men, mean age 78±7 years) with adequate data (mean follow-up; 48±20 months). Results: The angle of the proximal landing zone (LZ) (hazard ratio: 1.02, 95% confidence interval: 1.00-1.03, p=0.01) was recognized as an independent risk factor of sac growth (≥5 mm). The receiver operating characteristics curve (area under the curve: 0.72) showed a cutoff value of 47° of the minimum angle of the proximal LZ to predict sac growth. Freedom rates for persistent type Ia endoleaks were also found to be lower in the angulated group than those in the other groups (p=0.0095, log-rank). Conclusion: The angle of the proximal LZ was identified as an independent risk factor for sac growth post-EVAR. The incidence of persistent type Ia endoleaks was significantly higher in the angulated group.

Keywords: angulation; endoleak; endovascular aneurysm repair; instructions for use.

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Conflict of interest statement

Disclosure StatementAll authors have no conflict of interest.

Figures

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Fig. 1 Flowchart of study population and method.
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Fig. 2 Receiver operating characteristics curve analysis for angle and diameter of proximal landing zone.
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Fig. 3 The probability of freedom from persistent type Ia endoleak.
See this image and copyright information in PMC

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