Thesis
Incidence of type II endoleak after EVAR
- Course
- Institution
Complete thesis written at Het Rijnstate Hospital. Title: Comparison of the incidence of type 2 endoleak after EVAR between polyester and PTFE endografts.
[Show more]
Seller
Follow
maudkuijpers16
Content preview
Comparison of the incidence of type II endoleak afterEndovascular Aneurysm Repair with
polytetrafluoroethylene (PTFE) or polyester
endografts in patients electively treated for
abdominal aortic aneurysms
Maud Kuijpers m3.kuijpers@student.vu.nl
Student number 2679073
Major Clinical major
Course code AB_1196
EC 18
Name organization Rijnstate Arnhem
Department Vascular surgery
Daily supervisor Suzanne Holewijn SHolewijn@rijnstate.nl
VU supervisor Jan Blankensteijn j.blankensteijn@amsterdamumc.nl
Period of internship 7 maart 2022 t/m 3 juni 2022
,Table of content
1. Abstract
2. Introduction
3. Methods
3.1 Study design
3.2 Data extraction
3.3 Study population
3.4 Endpoints
3.5 Statistical analysis
4. Results
5. Discussion
6. Reference list
7. Reflection
8. Appendices (including additional analysis)
2
,1 Abstract
Background. Endoleak type II (T2EL), characterized by collateral backflow outside the endograft in the
aneurysm sac derived from aortic branches, is the most common complication after endovascular abdominal
aneurysm repair (EVAR). The nature of graft material for abdominal aortic aneurysms (AAA) endografts may be
expanded in most cases polytetrafluoroethylene (PTFE) or polyester. IDE trials suggest that there might be a
difference in the incidence of T2EL after EVAR between PTFE and polyester endografts. Therefore, the primary
aim of this study was to evaluate the 1-year incidence of T2ELs after EVAR between PTFE and polyester
endografts in patients electively treated for an infrarenal AAA.
Methods. A single centre, retrospective observational study, was conducted between 01-01-2011 and
January 01-01- 2022. 409 patients electively treated for an infrarenal AAA were identified in an existing local
AAA database. The primary endpoint was the incidence of T2EL occurring within 12 months after the EVAR-
procedure. Secondary endpoints included the presence of procedural T2ELs (< 24 h), early T2ELs (≤ 30 days),
late T2ELs (> 30 days), persistent T2ELs (lasting longer than six months), blood vessels responsible for T2ELs and
aneurysm remodeling in time. Kaplan-meyer analysis, univariate Cox regression and multivariate backward
stepwise Cox regression and non-parametric tests were used.
Results. The study sample for follow-up information included 402 patients. Most of the procedural T2ELs
(77.9%) disappeared during the follow-up period without performing reintervention, with significantly more
disappeared procedural T2ELs in the polyester group. There was no significant difference in the incidence of
T2ELs within 12 months after EVAR between the PTFE-group and PE-group (p=0.271). The incidence of T2ELs
(without the disappearance of procedural T2ELs) was significanlty higher in the PTFE group (p=0.010). There
was no significant difference between the incidence of procedural endoleaks, early endoleaks, late endoleaks
and persistent endoleaks (p=0.493;p=0.687;p=0.687; and p=0.905, respectively). The origin blood vessel
responsible for T2EL was significantly not different between the two groups (p=0.646). The mean time to the
first diagnosed T2EL was significantly not different between the two groups (p=0.504). The mean AAA
maximum diameter has decreased after EVAR, with no significant difference between the two groups
(p=0.084). Positive predictors for T2ELs within 12 months after EVAR were higher diastolic blood pressure and
larger infrarenal neck lenght for both the T2EL incidence with and without the disappeared procedural T2ELs
included (p<0.001;p=0.007). Smoking was only a predictive factor for T2ELs when disappeared procedural
T2ELs were not included (p=0.046).
Conclusion. There was no significant difference in the incidence of T2ELs within 12 months after EVAR between
PTFE and polyester endografts in patients electively treated for an infrarenal abdominal aortic aneurysm. Most
of the procedural T2ELs disappeared during the follow-up period. When disappeared procedural T2ELs were
not included, the incidence of T2ELs was significanlty higher in the PTFE group. Only higher diastolic blood
pressure and larger infrarenal neck length contributed to predicting T2EL after EVAR within 1 year follow-up.
When disappeared procedural T2ELs were not included, smoking was also a predictive factor for T2ELs.
3
, Keywords: Abdominal aortic aneurysm: Endovascular abdominal aneurysm repair: Endoleak type II:
Polytetrafluoroethylene: Polyester: Procedural type 2 endoleak.
4
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller maudkuijpers16. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $21.41. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
55628 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now