title: Risk factors for the development of persistent type II endoleaks after endovascular repair of infrarenal abdominal aortic aneurysms.
abstract: OBJECTIVE
  To determine, based on preoperative imaging findings, which patients treated with endovascular abdominal aneurysm repair are at high risk for the development of persistent type II endoleaks.
  
  
  METHODS
  Preoperative computed tomography (CT) angiographies of 136 patients, treated endovascularly, were retrospectively examined for possible anatomic predictors of type II endoleak development. Specifically, the number of patent aortic branches and thrombus load parameters (i.e., thickness, perimeter, area, and localization) were recorded. Thrombus load parameters were evaluated at the level of maximum aneurysm diameter, at the level of sac lumbar arteries' ostia, and at the level of inferior mesenteric artery ostium. Follow-up CT angiographies were also studied for the presence of persistent type II endoleaks (present at six-month follow-up examination). The association of these anatomic features with the development of persistent type II endoleaks was assessed using logistic regression analysis.
  
  
  RESULTS
  Aortic branch patency increased the risk for persistent type II endoleak development, while thrombus load parameters decreased this risk. In multiple logistic regression analysis, the total number of patent aortic branches (odds ratio = 4.23, 95% confidence interval = 1.72-10.42, P = 0.002 for each additional branch), and the percentage of aortic perimeter covered by a thrombus at the level of the sac lumbar arteries' ostia (odds ratio = 0.16, 95% confidence interval = 0.06-0.44, P < 0.001 for a 15% increase) were independent predictors.
  
  
  CONCLUSIONS
  Anatomic characteristics of a preoperative aorta can be used to predict patients with higher risk for persistent type II endoleak development.
authors: 2nd Department of Radiology, Attikon University Hospital, Athens, Greece.
authors: Elias
authors: E
authors: Brountzos
authors: Georgios
authors: G
authors: Karagiannis
authors: Irene
authors: I
authors: Panagiotou
authors: Chara
authors: C
authors: Tzavara
authors: Efstathios
authors: E
authors: Efstathopoulos
authors: Nikolaos
authors: N
authors: Kelekis
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery*; D057867:Endoleak / Q000145:classification* / Q000453:epidemiology*; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed