Type IIIb Endoleak Is Not Extremely Rare and May Be Underdiagnosed after Endovascular Aneurysm Repair

Naoki Fujimura, Shigeo Ichihashi, Kentaro Matsubara, Shintaro Shibutani, Hirohisa Harada, Hideaki Obara, Kimihiko Kichikawa, Yuukou Kitagawa

Research output: Contribution to journalArticle

Abstract

Purpose: To investigate the real incidence of type IIIb endoleaks associated with the Zenith stent graft, currently the most widely used third-generation polyester stent graft, in a Japanese multicenter database. Materials and Methods: Retrospective analysis was conducted of 433 patients who underwent endovascular aneurysm repair (EVAR) of aortoiliac aneurysms with the use of Zenith stent grafts from 2007 to 2016. The mean age of patients was 75.6 y ± 7.8, and 85.2% of patients were men. Mean transverse diameters of abdominal aortic aneurysms and common iliac artery aneurysms were 50.8 mm ± 9.9 and 42.2 mm ± 10.3, respectively. Results: During a mean follow-up period of 41.9 mo, 7 type IIIb endoleaks (1.6%) were identified. Four patients were definitively diagnosed during repeat intervention, and 3 were diagnosed based on postoperative CT images. Three patients were treated surgically, 2 were treated by relining with an additional stent graft, and 2 were conservatively followed with CT imaging. Only 1 of 5 patients who underwent repeat intervention had a preoperative diagnosis of type IIIb endoleak, reflecting the difficulty in its diagnosis. Conclusions: The incidence of type IIIb endoleak in Zenith stent grafts was 1.6% in this study, suggesting that type IIIb endoleaks are not extremely rare. In addition, type IIIb endoleak may be underdiagnosed or misdiagnosed as a different type of endoleak. Type IIIb endoleaks should always be considered in patients with sac expansion after EVAR.

Original languageEnglish
JournalJournal of Vascular and Interventional Radiology
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Endoleak
Aneurysm
Stents
Transplants
Iliac Aneurysm
Abdominal Muscles
Polyesters
Iliac Artery
Incidence
Abdominal Aortic Aneurysm
Diagnostic Errors
Databases

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Type IIIb Endoleak Is Not Extremely Rare and May Be Underdiagnosed after Endovascular Aneurysm Repair. / Fujimura, Naoki; Ichihashi, Shigeo; Matsubara, Kentaro; Shibutani, Shintaro; Harada, Hirohisa; Obara, Hideaki; Kichikawa, Kimihiko; Kitagawa, Yuukou.

In: Journal of Vascular and Interventional Radiology, 01.01.2019.

Research output: Contribution to journalArticle

@article{aee3f4b32a3e4547a54118f1a1ba1836,
title = "Type IIIb Endoleak Is Not Extremely Rare and May Be Underdiagnosed after Endovascular Aneurysm Repair",
abstract = "Purpose: To investigate the real incidence of type IIIb endoleaks associated with the Zenith stent graft, currently the most widely used third-generation polyester stent graft, in a Japanese multicenter database. Materials and Methods: Retrospective analysis was conducted of 433 patients who underwent endovascular aneurysm repair (EVAR) of aortoiliac aneurysms with the use of Zenith stent grafts from 2007 to 2016. The mean age of patients was 75.6 y ± 7.8, and 85.2{\%} of patients were men. Mean transverse diameters of abdominal aortic aneurysms and common iliac artery aneurysms were 50.8 mm ± 9.9 and 42.2 mm ± 10.3, respectively. Results: During a mean follow-up period of 41.9 mo, 7 type IIIb endoleaks (1.6{\%}) were identified. Four patients were definitively diagnosed during repeat intervention, and 3 were diagnosed based on postoperative CT images. Three patients were treated surgically, 2 were treated by relining with an additional stent graft, and 2 were conservatively followed with CT imaging. Only 1 of 5 patients who underwent repeat intervention had a preoperative diagnosis of type IIIb endoleak, reflecting the difficulty in its diagnosis. Conclusions: The incidence of type IIIb endoleak in Zenith stent grafts was 1.6{\%} in this study, suggesting that type IIIb endoleaks are not extremely rare. In addition, type IIIb endoleak may be underdiagnosed or misdiagnosed as a different type of endoleak. Type IIIb endoleaks should always be considered in patients with sac expansion after EVAR.",
author = "Naoki Fujimura and Shigeo Ichihashi and Kentaro Matsubara and Shintaro Shibutani and Hirohisa Harada and Hideaki Obara and Kimihiko Kichikawa and Yuukou Kitagawa",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jvir.2019.03.006",
language = "English",
journal = "Journal of Vascular and Interventional Radiology",
issn = "1051-0443",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Type IIIb Endoleak Is Not Extremely Rare and May Be Underdiagnosed after Endovascular Aneurysm Repair

AU - Fujimura, Naoki

AU - Ichihashi, Shigeo

AU - Matsubara, Kentaro

AU - Shibutani, Shintaro

AU - Harada, Hirohisa

AU - Obara, Hideaki

AU - Kichikawa, Kimihiko

AU - Kitagawa, Yuukou

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: To investigate the real incidence of type IIIb endoleaks associated with the Zenith stent graft, currently the most widely used third-generation polyester stent graft, in a Japanese multicenter database. Materials and Methods: Retrospective analysis was conducted of 433 patients who underwent endovascular aneurysm repair (EVAR) of aortoiliac aneurysms with the use of Zenith stent grafts from 2007 to 2016. The mean age of patients was 75.6 y ± 7.8, and 85.2% of patients were men. Mean transverse diameters of abdominal aortic aneurysms and common iliac artery aneurysms were 50.8 mm ± 9.9 and 42.2 mm ± 10.3, respectively. Results: During a mean follow-up period of 41.9 mo, 7 type IIIb endoleaks (1.6%) were identified. Four patients were definitively diagnosed during repeat intervention, and 3 were diagnosed based on postoperative CT images. Three patients were treated surgically, 2 were treated by relining with an additional stent graft, and 2 were conservatively followed with CT imaging. Only 1 of 5 patients who underwent repeat intervention had a preoperative diagnosis of type IIIb endoleak, reflecting the difficulty in its diagnosis. Conclusions: The incidence of type IIIb endoleak in Zenith stent grafts was 1.6% in this study, suggesting that type IIIb endoleaks are not extremely rare. In addition, type IIIb endoleak may be underdiagnosed or misdiagnosed as a different type of endoleak. Type IIIb endoleaks should always be considered in patients with sac expansion after EVAR.

AB - Purpose: To investigate the real incidence of type IIIb endoleaks associated with the Zenith stent graft, currently the most widely used third-generation polyester stent graft, in a Japanese multicenter database. Materials and Methods: Retrospective analysis was conducted of 433 patients who underwent endovascular aneurysm repair (EVAR) of aortoiliac aneurysms with the use of Zenith stent grafts from 2007 to 2016. The mean age of patients was 75.6 y ± 7.8, and 85.2% of patients were men. Mean transverse diameters of abdominal aortic aneurysms and common iliac artery aneurysms were 50.8 mm ± 9.9 and 42.2 mm ± 10.3, respectively. Results: During a mean follow-up period of 41.9 mo, 7 type IIIb endoleaks (1.6%) were identified. Four patients were definitively diagnosed during repeat intervention, and 3 were diagnosed based on postoperative CT images. Three patients were treated surgically, 2 were treated by relining with an additional stent graft, and 2 were conservatively followed with CT imaging. Only 1 of 5 patients who underwent repeat intervention had a preoperative diagnosis of type IIIb endoleak, reflecting the difficulty in its diagnosis. Conclusions: The incidence of type IIIb endoleak in Zenith stent grafts was 1.6% in this study, suggesting that type IIIb endoleaks are not extremely rare. In addition, type IIIb endoleak may be underdiagnosed or misdiagnosed as a different type of endoleak. Type IIIb endoleaks should always be considered in patients with sac expansion after EVAR.

UR - http://www.scopus.com/inward/record.url?scp=85067095187&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067095187&partnerID=8YFLogxK

U2 - 10.1016/j.jvir.2019.03.006

DO - 10.1016/j.jvir.2019.03.006

M3 - Article

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

ER -