title: Risk factors of endoleak following endovascular repair of abdominal aortic aneurysm. A multicentric retrospective study.
abstract: Endoleak (EL) represents the most common complication following endovascular abdominal aortic aneurysm repair (EVAR). Unfortunately, the long-term results of EVAR and its durability have been questioned, and EL are variably associated with a risk of late failure. The aim of this retrospective study was to identify risk factors for this complication of aneurysm-endograft complex in patients who underwent EVAR. A group of 104 consecutive patients (99 men, 5 women; median age, 74 years; range, 50-89 years) were enrolled in the study. Both preoperative and follow-up imaging studies were obtained using helical computed tomography scanning at 1, 6, 12, 24, 36 months after EVAR and blindly reviewed by a surgeon and a radiologist. Twenty-seven (25.9%) patients developed EL during follow-up, of which 10 (37%) were primary (<30 days from EVAR), and 17 (63%) were secondary EL. Age and smoking did not affect the EL onset, while a body mass index >25 and a history or presence of arterial hypertension represented significant (p<0.05) risk factors. Moreover, both greatest diameter and maximum length of the aneurysm were significantly higher (p<0.01) in patients who developed EL. No relationship was found with the anatomical features of the aortic neck (i.e. length and diameter), and between the initial size of the aneurysm and the dimension at the time of EL. In conclusion, in our study, being overweight, arterial hypertension and the initial size of the aneurysm represent risk factors for EL development.
authors.affiliation: Department of Surgical & Gastroenterological Sciences, University of Padua, School of Medicine, Padova, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Frego
authors.forename: Franco
authors.initials: F
authors.lastname: Lumachi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bianchera
authors.forename: Fabio
authors.initials: F
authors.lastname: Pilon
authors.forename: Marco
authors.initials: M
authors.lastname: Scarpa
authors.forename: Cesare
authors.initials: C
authors.lastname: Ruffolo
authors.forename: Lino
authors.initials: L
authors.lastname: Polese
authors.forename: Imerio
authors.initials: I
authors.lastname: Angriman
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Norberto
authors.forename: Diego
authors.initials: D
authors.lastname: Miotto
authors.forename: Raffaella
authors.initials: R
authors.lastname: Motta
authors.forename: Antonio
authors.initials: A
authors.lastname: Zanon
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Picchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014656:Vascular Surgical Procedures / Q000009:adverse effects*