title: Real-world experience with type I endoleaks after endovascular repair of the thoracic aorta.
abstract: Endoleaks are a frequent complication of thoracic endovascular aortic repair (TEVAR) and will likely increase in incidence with application of the technique to more complicated aortic anatomy and a wider range of thoracic aortic pathologies. Management generally consists of aggressive repair of Type I endoleaks; however, the natural history of Type I endoleaks after TEVAR remains largely unknown. The purpose of this study was to examine the incidence and characteristics of Type I endoleaks and to evaluate clinical outcomes of patients with Type I endoleaks after TEVAR. A single-center retrospective review was performed on all patients who underwent TEVAR over a 4-year period. Type I endoleaks were detected in 21 per cent (27 of 129) of patients on post-deployment aortography or CT angiography. During a mean follow-up of 750.63 +/- 483 days, 59 per cent (16 of 27) closed spontaneously; 30 per cent (eight of 27) required secondary endovascular intervention; and 11 per cent (three of 27) have persisted with no increase in maximum aortic diameter. No patients have died or required open surgical conversion as a result of their Type I endoleak. Although accurate predictors of spontaneous resolution of Type I endoleaks have yet to be definitively characterized, our initial results suggest that it may be safe to observe small Type I endoleaks given that a large percentage resolve spontaneously and no endoleak-related deaths have occurred.
authors.affiliation: Department of Radiology, University of Virginia Health System, Charlottesville, Virginia 22908, USA. jda2d@virginia.edu
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Adams
authors.forename: Margaret C
authors.initials: MC
authors.lastname: Tracci
authors.forename: Sahir
authors.initials: S
authors.lastname: Sabri
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Cherry
authors.forename: John F
authors.initials: JF
authors.lastname: Angle
authors.forename: Alan H
authors.initials: AH
authors.lastname: Matsumoto
authors.forename: John A
authors.initials: JA
authors.lastname: Kern
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D012189:Retrospective Studies