Clinical significance of endoleaks characterized by computed tomography during aortography performed immediately after endovascular abdominal aortic aneurysm repair: prediction of persistent endoleak.
OBJECTIVE
This study aimed to predict the persistence of endoleaks (ELs) using patterns and volumes evaluated by computed tomography during aortography (CTDA) performed immediately after endovascular abdominal aortic aneurysm repair (EVAR).


METHODS
CTDA immediately after EVAR and at the 6-month follow-up CT were performed in 52 patients. ELs were classified as localized-type pattern (LTP; <180° around the center of the aneurysmal lumen) or circumferential-type pattern (CTP; >180°). The proportion of EL volume in the aneurysmal sac, excluding mural thrombus, was classified as grade A (≤5 %), B (5-10 %), or C (≥10 %). The 6-month follow-up residual rates were evaluated, and volume ratios (follow-up CT aneurysmal volume including mural thrombus/CTDA aneurysmal volume) were calculated.


RESULTS
The residual rate (5.3 %) and mean volume ratio (83.9 %) of ELs with LTP were significantly lower than those of ELs with CTP (72.2 and 99.3 %, respectively); there was no significant difference in residual rate or mean volume ratio among EL grades (A: 17.6, 88.1 %; B: 55.6, 89.7 %; C: 54.5, 97.8 %).


CONCLUSIONS
ELs with LTP generally disappear over time after EVAR, with a concomitant reduction in aneurysm volume, whereas those with CTP persist, indicating that patients with EL with a CTP should be followed up carefully.
Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama 641-8510, Japan. momonga@wakayama-med.ac.jp
Motoki
M
Nakai
Hirotatsu
H
Sato
Morio
M
Sato
Yuko
Y
Tanba
Yasutaka
Y
Noda
Akira
A
Ikoma
Hiroki
H
Sanda
Kohei
K
Nakata
Hiroki
H
Minamiguchi
Nobuyuki
N
Kawai
Tetsuo
T
Sonomura
Kazushi
K
Kishi
Yosiharu
Y
Nishimura
Yoshitaka
Y
Okamura
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D003287:Contrast Media; D057867:Endoleak; D005260:Female; D006801:Humans; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007479:Iopamidol