1. Impact of Isolated Type 2 Endoleak on Subsequent Cardiovascular Events and Mortality.
- Author
-
Rivoire E, Tresson P, Pialoux V, Josset L, Delrieu L, Millon A, and Long A
- Subjects
- Humans, Male, Retrospective Studies, Female, Aged, Risk Factors, Time Factors, Treatment Outcome, Aged, 80 and over, Risk Assessment, Computed Tomography Angiography, Cardiovascular Diseases mortality, Cause of Death, Aortic Aneurysm, Abdominal surgery, Aortic Aneurysm, Abdominal mortality, Aortic Aneurysm, Abdominal diagnostic imaging, Endoleak etiology, Endoleak mortality, Endoleak diagnostic imaging, Endovascular Procedures adverse effects, Endovascular Procedures mortality, Blood Vessel Prosthesis Implantation adverse effects, Blood Vessel Prosthesis Implantation mortality
- Abstract
Background: Assess subsequent cardiovascular events and all-cause mortality in patients with intact abdominal aortic aneurysm (AAA) treated by endovascular aneurysm repair (EVAR) according to the existence of isolated endoleak type 2 (EL
2 ) at 1 year after EVAR implantation., Methods: This retrospective, single-center study included patients treated with EVAR between 2010 and 2017 in the vascular surgery department of the University Hospital of Lyon with an infrarenal AAA > 50 mm. The baseline clinical characteristics collected just before EVAR were retrieved from electronic patient records of our institution. AAA characteristics, procedure, and the 1-year postoperative computed tomography angiography (CTA) were reported. Study end points, major adverse cardiovascular events (MACE), major adverse lower-extremity events (MALE), and all-cause mortality were recorded during follow-up. Patients were divided into 2 groups according to the presence of isolated EL2 (EL2 +) or absence (EL2 -) of any endoleak on CTA at 1 year. MACE, MALE, and all-cause mortality were compared between both groups., Results: During the study period, 589 patients were treated by endovascular surgery and 207 were included. According to the CTA results at 1 year, 60 patients (29%) were included in the EL2 + group and 147 patients (71%) in the EL2 - group. A total of 109 patients (53%) experienced a MACE or MALE; significantly fewer patients in the EL2 + than in the EL2 - group did so (P = 0.009). There were 47 patients (23%) who experienced at least 1 MALE, and the frequency was significantly lower in the EL2 + group (P = 0.017)., Conclusions: Patients with AAA treated by EVAR who did not develop EL2 at 1 year were at higher risk of MALE during follow-up. This might be explained by more frequent symptomatic lower extremity peripheral arterial disease at baseline in this group. These patients therefore require a closer follow-up and strict control of cardiovascular risk factors to prevent cardiovascular morbi-mortality., (Copyright © 2024 Elsevier Inc. All rights reserved.)- Published
- 2024
- Full Text
- View/download PDF