Prevalence and risk factors of type II endoleaks after endovascular aneurysm repair: A meta-analysis.
OBJECTIVE
This systematic review and meta-analysis aims to determine the current evidence on risk factors for type II endoleaks after endovascular aneurysm repair (EVAR).


METHODS
A systematic literature search was carried out for studies that evaluated the association of demographic, co-morbidity, and other patient-determined factors with the onset of type II endoleaks. Pooled prevalence of type II endoleaks after EVAR was updated.


RESULTS
Among the 504 studies screened, 45 studies with a total of 36,588 participants were included in this review. The pooled prevalence of type II endoleaks after EVAR was 22% [95% confidence interval (CI), 19%-25%]. The main factors consistently associated with type II endoleaks included age [pooled odds ratio (OR), 0.37; 95% CI, 0.31-0.43; P<0.001], smoking (pooled OR, 0.71; 95% CI, 0.55-0.92; P<0.001), patent inferior mesenteric artery (pooled OR, 1.98; 95% CI, 1.06-3.71; P = 0.012), maximum aneurysm diameter (pooled OR, 0.23; 95% CI, 0.17-0.30; P<0.001), and number of patent lumbar arteries (pooled OR, 3.07; 95% CI, 2.81-3.33; P<0.001). Sex, diabetes, hypertension, anticoagulants, antiplatelet, hyperlipidemia, chronic renal insufficiency, types of graft material, and chronic obstructive pulmonary diseases (COPD) did not show any association with the onset of type II endoleaks.


CONCLUSIONS
Clinicians can use the identified risk factors to detect and manage patients at risk of developing type II endoleaks after EVAR. However, further studies are needed to analyze a number of potential risk factors.
Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Qiang
Q
Guo
Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Xiaojiong
X
Du
Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Jichun
J
Zhao
Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Yukui
Y
Ma
Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Bin
B
Huang
Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Ding
D
Yuan
Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Yi
Y
Yang
Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Guojun
G
Zeng
Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Fei
F
Xiong
D057867:Endoleak / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D014656:Vascular Surgical Procedures / Q000009:adverse effects*