Multisciplinary Management of Endoleaks After Endovascular Aneurysm Repair by Creation of the Endoleak Team

The presence of any kind endoleak (EL) can jeopardize the durability endovascular aneurysm repair (EVAR). aim this study was to evaluate role an EL Team in management after EVAR. Patients with type I ELs or II sac expansion >1 cm were included single-center, retrospective study. A multidisciplinary team (EL Team) involving vascular surgeons and interventional radiologists set up for 2015. Before 2015, only involved treatment. Technical success, mortality, occurrence complications, surgical conversion rate, analyzed at 2-year follow-up. Two groups created: group treated by between 2011 2014 B Seventy included: 37 (21 II, 16 I) 33 (19 14 I). In Table are listed types reinterventions performed. Of note, a nonoperative approach performed 11 (53%) ELs, use coil embolization as method treatment significantly more applied B. All received intervention. During follow-up period, one aneurysm-related death occurred both due rupture (group A: 2.7%; B: 3%; P = 1), two other adjunctive non-aneurysm-related deaths (P 1). success 80.8% vs 100% .013) B, respectively. Group presented lower probability developing .002, odds ratio 0.137, NegelkerkeR2 0.30). As illustrated Kaplan-Meier curves, had rate compared (log rank 0.001). Freedom from 12, 18, 24 months 69.4%, 63.9%, 33.3%, 93.9%, 90.7%, 78.8% No major complications reported whereas case graft migration requiring described A; minor periprocedural without significant differences 3% 1.000). At follow-up, 4 (10.8%) patients converted A, none .11). introduction clinical practice center is safe makes it possible treat effectively, promoting technical reducing More data long-term required confirm our findings.TableTypes reinterventionsGroup AN 37Group BN 33P valueType endoleaks,N (%)16 (43)14 (42) Treated embolization3 (19)9 (64).02 cuff13 (81)(2 chimneys)5 (36).02Type endoleaks, N (%)21 (57)19 (52) Conservative management11 (53)0 (0)<.0002 Direct puncture3 (14)4 (21).68 Transarterial embolization4 (19)15 (79).0003 Laparoscopic surgery3 (14)0 (0).23 Open table new tab