Incidence and Fate of Refractory Type II Endoleak after EVAR: A Retrospective Experience of Two High-Volume Italian Centers
Abstract
:1. Introduction
2. Materials and Methods
2.1. Statistical Analysis
2.2. Ethical Requirements
3. Results
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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TIIEL Requiring Reintervention (102 Patients) | TIIEL Solved after Redo Endovascular Procedure (52 Patients) | Refractory TIIEL (50 Pts) | p (OR; CI95%) | |
---|---|---|---|---|
Mean Age (years ± SD) | 77.32 ± 8.08 | 77.42 ± 7.62 | 77.22 ± 8.60 | 0.449909 |
Male Sex (n; %) | 88; 86.27 | 43; 82.69 | 45; 90 | 0.28 (0.53; 0.16–1.71) |
Hypertension (n; %) | 82; 80.39 | 38; 73.08 | 44; 88 | 0.057 (0.37; 0.12–1.05) |
CAD (n; %) | 41; 40.19 | 14; 26.92 | 27; 54 | 0.005 (3.18; 1.3–7.2) |
Dyslipidemia (n; %) | 39; 38.23 | 20; 38.46 | 19; 38 | 0.90 (1.01; 0.45–2.26) |
Smoking History (n; %) | 32; 31.37 | 18; 34.62 | 14; 28 | 0.47 (1.36; 0.58–3.15) |
COPD (n; %) | 27; 26.47 | 16; 30.77 | 11; 22 | 0.31 (1.57; 0.64–3.84) |
Diabetes (n; %) | 19; 18.62 | 10; 19.23 | 9; 18 | 0.87 (1.08; 0.39–2.92) |
ASA Classification | ||||
I (n; %) | 0 | 0 | 0 | - |
II (n; %) | 28; 27.45 | 15; 28.85 | 13; 26 | 0.06 (0.40; 0.15–1.07) |
III (n; %) | 56; 54.9 | 25; 48.08 | 31; 62 | 0.15 (0.56; 0.25–1.24) |
IV (n; %) | 18; 17.65 | 12; 23.08 | 6; 12 | 0.14 (2.2; 0.75–6.41) |
TIIEL Requiring Reintervention (102 Patients) | TIIEL Solved after Redo Endovascular Procedure (52 Patients) | Refractory TIIEL (50 Pts) | p (OR; CI95%) | |
---|---|---|---|---|
Preoperative AAA diameter (mm ± SD) | 64.7 ± 14.02 | 65.43 ± 11.96 | 73.3 ± 16.71 | 0.0055 |
Patent IMA (n; %) | 55; 53.92 | 22; 42.31 | 33; 66 | 0.016 (2.64; 1.18–5.90) |
Patent lumbar arteries | ||||
1 couple (n; %) | 7; 6.87 | 4; 7.69 | 3; 6 | 0.73 (0.76; 0.16–3.6) |
2 couples (n; %) | 50; 49.01 | 40; 76.92 | 10; 20 | >0.0001 (0.075; 0.02–0.19) |
3 couples (n; %) | 37; 36.27 | 7; 13.46 | 30; 60 | >0.0001 (9.64; 3.63–25.6) |
>3 couples (n; %) | 8; 7.84 | 1; 1.92 | 7; 14 | 0.02 (8.30; 0.98–70.1) |
TIIEL Requiring Reintervention (102 Patients) | TIIEL Solved after Redo Endovascular Procedure (52 Patients) | Refractory TIIEL (50 Pts) | p (OR; CI95%) | |
---|---|---|---|---|
Excluder (n; %) | 52; 50.98 | 19; 36.53 | 33; 66 | 0.017772 (11.9441) |
Endurant (n; %) | 14; 13.72 | 9; 17.31 | 5; 10 | |
Zenith (n; %) | 24; 23.52 | 14; 26.92 | 10; 20 | |
Ovation (n; %) | 10; 9.8 | 9; 17.31 | 1; 2 | |
Talent (n; %) | 2; 1.98 | 1; 1.93 | 1; 2 |
TIIEL Requiring Reintervention (102 Patients) | TIIEL Solved after Redo Endovascular Procedure (52 Patients) | Refractory TIIEL (50 Pts) | p (OR; CI95%) | |
---|---|---|---|---|
Isolated standard EVAR | 49; 48.03 | 12; 23.08 | 37; 74 | >0.0001 (9.48; 3.84–23.4) |
EVAR + sac embolization | 28; 27.45 | 18; 34.62 | 10; 20 | 0.09 (0.47; 0.19–1.15) |
EVAR + IMA embolization | 25; 24.52 | 22; 42.31 | 3; 6 | >0.0001 (0.08; 0.02–0.31) |
TIIEL Requiring Reintervention (102 Patients) | TIIEL Solved after Redo Endovascular Procedure (52 Patients) | Refractory TIIEL (50 Pts) | p (OR; CI95%) | |
---|---|---|---|---|
IMA embolization | 23; 22.54 | 14; 26.92 | 9; 18 | 0.28 (0.59; 0.23–1.53) |
Sac embolization | 42; 41.17 | 7; 13.46 | 35; 70 | >0.0001 (15; 5.51–40.7) |
Lumbar arteries embolization | 34; 33.33 | 28; 53.84 | 6; 12 | >0.0001 (0.11; 0.04–0.32) |
IMA laparoscopic ligation | 3; 2.96 | 3; 5.78 | / | 0.08 (NA) |
Refractory TIIEL | |||
---|---|---|---|
Included Variables | Excluded Variables | ||
p | (OR; CI95%) | ||
Preoperative AAA diameter > 65 mm at first EVAR procedure | 0.03 | (11.7; 1.27–107.9) | Patent IMA |
IMA embolization | 0.0002 | (0.0043; 0.0002–0.077) | CAD |
Sac embolization | <0.0001 | (0.0013; 0.0001–0.0210) | 2 couples |
Lumbar arteries embolization | 0.0009 | (0.009; 0.0006–0.14) | 3 couples |
>3 couples | |||
Isolated standard EVAR | |||
ROC curve analysis | |||
Area under the ROC curve (AUC) | Standard Error | CI95% | |
0.96 | 0.017 | 0.91–0.99 |
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Sirignano, P.; Mangialardi, N.; Nespola, M.; Aloisi, F.; Orrico, M.; Ronchey, S.; Del Porto, F.; Taurino, M. Incidence and Fate of Refractory Type II Endoleak after EVAR: A Retrospective Experience of Two High-Volume Italian Centers. J. Pers. Med. 2022, 12, 339. https://doi.org/10.3390/jpm12030339
Sirignano P, Mangialardi N, Nespola M, Aloisi F, Orrico M, Ronchey S, Del Porto F, Taurino M. Incidence and Fate of Refractory Type II Endoleak after EVAR: A Retrospective Experience of Two High-Volume Italian Centers. Journal of Personalized Medicine. 2022; 12(3):339. https://doi.org/10.3390/jpm12030339
Chicago/Turabian StyleSirignano, Pasqualino, Nicola Mangialardi, Martina Nespola, Francesco Aloisi, Matteo Orrico, Sonia Ronchey, Flavia Del Porto, and Maurizio Taurino. 2022. "Incidence and Fate of Refractory Type II Endoleak after EVAR: A Retrospective Experience of Two High-Volume Italian Centers" Journal of Personalized Medicine 12, no. 3: 339. https://doi.org/10.3390/jpm12030339
APA StyleSirignano, P., Mangialardi, N., Nespola, M., Aloisi, F., Orrico, M., Ronchey, S., Del Porto, F., & Taurino, M. (2022). Incidence and Fate of Refractory Type II Endoleak after EVAR: A Retrospective Experience of Two High-Volume Italian Centers. Journal of Personalized Medicine, 12(3), 339. https://doi.org/10.3390/jpm12030339