Management of Immediate Post-Endovascular XXXX Repair Type Ia Endoleaks and Late Outcomes.

@entity1 @entity449 @entity1070
BACKGROUND: Post endovascular @entity449 repair (EVAR) @entity1070 and the need for reintervention are challenging. Additional endovascular treatment is advised for Type Ia @entity1070 detected on post-EVAR completion angiogram. This study analyzes management and late outcome of these @entity1070 . @entity1 POPULATION AND METHODS: This is a retrospective review of prospectively collected date of EVAR @entity1 during a 10-year period. All post-EVAR Type Ia @entity1070 on completion angiogram were identified (Group A) and their early (30-day) and late outcomes were compared to @entity1 without @entity1070 (Group B). A Kaplan-Meier analysis was used for survival analysis, sac expansion, late Type Ia endoleak, and reintervention. RESULTS: 71/565 (12.6%) @entity1 had immediate post-EVAR Type Ia endoleak. Early intervention (proximal aortic cuffs and/or stenting) was used in 56/71 (79%) in Group A versus 31/494 (6%) in Group B (p<0.0001). Late Type Ia endoleak was noted in nine @entity1 (13%) in Group A at a mean follow-up of 28 months versus 10 @entity1 (2%) in Group B at a mean follow-up of 32 months (p<0.0001). Late sac expansion and reintervention rates were: 9% and 10% for Group A versus 5% and 3% for Group B (p=0.2698 and p-0.0198), respectively. Freedom rates from late Type Ia @entity1070 at 1, 3, and 5 years for Group A were 88%, 85%, and 80% versus 98%, 98%, and 96% for Group B (p<0.001); and for late intervention, 94%, 92%, and 77% for Group A, and 99%, 97%, and 95% for Group B (p=0.007), respectively. Survival rates were similar. CONCLUSIONS: Immediate post-EVAR Type Ia @entity1070 are associated with higher rates of early interventions and late @entity1070 and re-intervention, which will necessitate strict post-EVAR surveillance.
