ReviewJournal of vascular surgery2023
The impact of completion and follow-up endoleaks on survival, reintervention, and rupture.
Review in Journal of vascular surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 18 citations in OpenAlex.
- Global burden of aortic aneurysm from high body mass index and systolic blood pressure in older adults: 1990-2021 and projections to 2050.Archives of medical science : AMS · 2026Article
- Retrospective Review of Surgical Techniques in the Management of Abdominal Aortic Aneurysms.Journal of pharmacy & bioallied sciences · 2025Article
- Hemodynamic analysis of thoracic endovascular aortic repair with left subclavian artery reconstructed by chimney stent.Vascular · 2025Article
- Long-Term Outcomes in Patients Managed with the EndurantJournal of clinical medicine · 2024Article
- Patient-Tailored Therapy for Complex Aortic Arch Anatomy: An Evolving Research Field with Custom-Made Solutions.Journal of clinical medicine · 2024Review
- Understanding Type II Endoleak: A Harmless Imaging Finding or a Silent Threat?Journal of clinical medicine · 2024Review
- Implantable Pressure-Sensing Devices for Monitoring Abdominal Aortic Aneurysms in Post-Endovascular Aneurysm Repair.Sensors (Basel, Switzerland) · 2024Review
- The impact of dyslipidemia on prognosis of patients after endovascular abdominal aortic aneurysm repair.Frontiers in cardiovascular medicine · 2024Article
- Three-dimensional simulations for planning fenestrated/branched endografts in endovascular aneurysm repair for complex abdominal aortic aneurysm: a retrospective cohort study.Therapeutic advances in cardiovascular diseaseArticle
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveEndoleaks may be seen at case completion of endovascular abdominal aortic aneurysm repair (EVAR), and the presence of an endoleak may impact outcomes. However, the clinical implications of various endoleaks seen during follow-up is not well-described. Therefore, we studied the impact of endoleaks at completion and at follow-up on mid-term outcomes.
methodsWe reviewed patients who underwent EVAR from 2003 to 2016 within the Vascular Quality Initiative-Medicare database and identified patients with endoleak at procedure completion and during follow-up, excluding those presenting with rupture. We stratified cohorts by presence of completion and follow-up endoleak subtypes. The primary outcome was 5-year survival, and secondary outcomes included 5-year freedom from reintervention and freedom from rupture. We used Kaplan-Meier estimates and log-rank tests to analyze differences in time-to-event endpoints.
resultsOf 21,745 patients with completion endoleak data, 5085 (23%) had an endoleak. Compared with those without endoleak, those with type I endoleaks had lower 5-year survival (69% vs 75%; P < .001), type II endoleaks had higher survival (79%; P < .001), and types III, IV, and indeterminate were not statistically different (73%, 73%, and 75%, respectively). Freedom from reintervention for types I and III endoleaks were significantly lower than no endoleak cohort (I: 76%; P < .001; III: 72%; P < .001 vs 83%), but freedom from rupture was higher for those with type II and III endoleak (95% and 97% vs 94%; P < .001). Of 14,479 patients with detailed follow-up endoleak data, 2290 (16%) had an endoleak. Compared with those without endoleak, types I and III had significantly lower 5-year survival (I: 80%; P = .002; III: 66%; P < .001 vs 84%), but there were no differences for types II (82%) and indeterminate (77%). Those with any type of follow-up endoleak had lower 5-year freedom from reintervention (I: 70%; P < .001; II: 76%; P = .006; III: 36%; P < .001; indeterminate: 60%; P = .007 vs 84%), and lower freedom from rupture (I: 92%; P < .001; II: 91%; P = .16; III: 88%; P = .01; indeterminate: 90%; P = .11 vs 94%).
conclusionsCompared with patients with no endoleak, those with type I completion endoleaks have lower 5-year survival and freedom from reintervention. Patients with types I and III follow-up endoleaks also have lower survival, and any endoleak at follow-up is associated with lower freedom from reintervention and freedom from rupture. These data highlight the importance of careful patient selection and close postoperative follow-up after EVAR, as the presence of endoleaks, specifically type I and III, over time portends worse outcomes.
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