title: Analysis of anatomical risk factors for persistent type II endoleaks following endovascular abdominal aortic aneurysm repair using CT angiography.
abstract: OBJECTIVE
  To predict persistent type II endoleaks (pT2Es) following endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms, we examined factors related to post-EVAR pT2Es.
  
  
  METHODS
  Eighty-four cases of EVAR were analyzed. T2Es that persisted for ≥6 months were defined as pT2Es. pT2Es flowing from an inferior mesenteric artery (IMA) and lumbar artery (LA) were termed pIMA-T2Es and pLA-T2Es, respectively. The anatomical factors concerning the aneurysm, IMA and LAs were assessed in the preoperative CT angiography images. A statistical analysis was performed on the factors associated with pT2Es.
  
  
  RESULTS
  The incidence of pT2Es was 25 %. pT2Es were associated with postoperative changes in the aneurysm diameter. A univariate analysis showed that a sac thrombus and the number of patent side branches arising from an aneurysm were significant factors associated with pT2Es. The IMA diameters were significantly larger in cases of pIMA-T2Es. The significant factors associated with pLA-T2Es were a circumferential thrombus, the number of patent LAs and the mean LA diameter. Multivariate analyses indicated that a circumferential thrombus was a protective factor for pT2Es, whereas an IMA ≥2.6 mm and each additional LA branch ≥1.9 mm were powerful risk factors for a pT2E.
  
  
  CONCLUSIONS
  Significant anatomical factors associated with pT2E were found in this study. These factors may be useful in selecting patients for perioperative intervention.
authors.affiliation: Department of Cardiovascular Surgery, Chiba Kaihin Municipal Hospital, 3-31-1, Isobe, Mihama-ku, Chiba, Chiba, 261-0012, Japan. czf14410@nifty.com.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Otsu
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ishizaka
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Cardiovascular Surgery, Chiba Nishi General Hospital, Chiba, Japan.
authors.forename: Takaki
authors.initials: T
authors.lastname: Hori
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kohno
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ishida
authors.affiliation: Department of Cardiovascular Surgery, Chiba Kaihin Municipal Hospital, 3-31-1, Isobe, Mihama-ku, Chiba, Chiba, 261-0012, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Nakaya
authors.affiliation: Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Goro
authors.initials: G
authors.lastname: Matsumiya
keywords: Abdominal aortic aneurysm; CT angiography; Endovascular repair; Type II endoleak