Sac Behavior Serves as a Strong Prognosticator for Development of Late Endoleak in Patients Without Early Endoleak

Endoleak is a known complication of endovascular aortic repair (EVAR). The purpose this study was to identify trends in the development late endoleak based on initial aneurysm sac behavior. We analyzed 1631 patients who underwent EVAR for abdominal at single center between 2001 and 2020. Patients were stratified into no leak or groups then further grouped by behavior: expansion, stabilization, regression. Endoleaks confirmed computed tomography scan, magnetic resonance imaging, angiography. Statistical analysis performed using χ2 odds ratios. Among EVAR, 917 (56.2%) had first follow-up. Of these 917, 498 (54.3%) regression, 241 (26.28%) 178 (19.4%) stable. At mean follow-up 52.6 ± 42.0 months, regression group showed 377 (76.7%) with continued 5 (1.0%) developed type I endoleak, 25 (5.0%) II 1 (0.2%) III 9 (1.8%) unspecified endoleaks, 81 (16.2%) contrast done due contraindications expansion follow up 59.5 months 48.9 123 (51.3%) 31 (13.2%) 32 (13.3%) 2 (0.8%) 10 (4.2%) endoleak. stable 27.7 32.5 months. One hundred thirty-two (74.2%) has (1.1%) 12 (6.8%) (0.6%) unspecified. Sac associated fewer endoleaks when compared nonregression (9.8% vs 26.5%; P < .001). Nonregression 6.79-fold more likely develop 1.79-fold (Table). Regression 2.7-fold experience absence less have sustained exclusion. This confirms that most important prognostic metric successful EVAR.TableOdds ratio (OR) presence across behavior groupsNo Leak, regressionNo leak, stabilizationNo expansionOR (95% CI)P valueType endoleak53026.79 (2.60-17.5)<.0001Type endoleak2329101.79 (1.04-3.05).034Type endoleak1213.16 (0.33-30.5).994Persistent endoleak3601151420.37 (0.24-0.59)<.0001Boldface entries indicate statistical significance. Open table new tab