title: Predictive factors for endoleaks after thoracic aortic aneurysm endograft repair.
abstract: BACKGROUND
  Our prospective investigation aimed to determine and analyze the incidence and the determinants of endoleaks after thoracic stent graft.
  
  
  METHODS
  Sixty-one patients affected by thoracic aortic aneurysms were treated between January 2000 and March 2008. The study cohort contained 54 men, with a mean age of 63.6 +/- 17.9 years. The follow-up imaging protocol included chest radiographs and triple-phase computed tomographic angiography performed at 1, 4, and 12 postoperative months and annually thereafter.
  
  
  RESULTS
  Median follow-up was 32.4 months (range: 1-96 months). Endoleaks were detected in 9 (14.7%) patients, of which 7 were type 1. Five endoleaks were detected at 30 postoperative days, and the other 4 developed with a mean delay of 12 months. Endovascular or hybrid interventions were used to treat the endoleaks. Secondary technical success rate was 100%. Multivariate analysis demonstrated that the diameter of the aneurysmal aorta (odds ratio 1.75, 95% confidence interval 1.07-2.86) and the coverage of the left subclavian artery (odds ratio 12.05, 95% confidence interval 1.28-113.30) were independently associated with endoleak development. The percentages of patients in whom reinterventions were unnecessary were 94.6% +/- 3.0%, 88.3% +/- 4.5%, and 85.4% +/- 5.2%, at 1, 2, and 5 years, respectively. The actuarial survival estimates at 1, 2, and 5 years were 85.2% +/- 4.6%, 78.1% +/- 5.4%, and 70.6% +/- 6.4%, respectively.
  
  
  CONCLUSIONS
  The diameter of the aneurysmal aorta and the position of the landing zone are independent predictors of endoleak occurrence after thoracic stent-graft procedures. A careful follow-up program should be considered in patients in whom these indices are unfavorable, because most of the endoleaks may be successfully and promptly treated by additional endovascular procedures.
authors: Department of Surgical Sciences, Vascular Surgery Unit, Varese University Hospital, Varese, Italy.
authors: Gabriele
authors: G
authors: Piffaretti
authors: Giovanni
authors: G
authors: Mariscalco
authors: Chiara
authors: C
authors: Lomazzi
authors: Nicola
authors: N
authors: Rivolta
authors: Francesca
authors: F
authors: Riva
authors: Matteo
authors: M
authors: Tozzi
authors: Gianpaolo
authors: G
authors: Carrafiello
authors: Alessandro
authors: A
authors: Bacuzzi
authors: Monica
authors: M
authors: Mangini
authors: Maciej
authors: M
authors: Banach
authors: Patrizio
authors: P
authors: Castelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D055815:Young Adult