Prevalence of type II endoleak after elective endovascular aneurysm repair with polytetrafluoroethylene- or polyester-based endografts

Maud Kuijpers; Suzanne Holewijn; Jan D Blankensteijn; Michel M P J Reijnen

doi:10.1016/j.jvs.2023.09.019

Prevalence of type II endoleak after elective endovascular aneurysm repair with polytetrafluoroethylene- or polyester-based endografts

J Vasc Surg. 2024 Jan;79(1):24-33. doi: 10.1016/j.jvs.2023.09.019. Epub 2023 Sep 19.

Authors

Maud Kuijpers¹, Suzanne Holewijn¹, Jan D Blankensteijn², Michel M P J Reijnen³

Affiliations

¹ Department of Surgery, Rijnstate, Arnhem, the Netherlands.
² Department of Vascular Surgery, Amsterdam UMC, Amsterdam, the Netherlands.
³ Department of Surgery, Rijnstate, Arnhem, the Netherlands; Multi-Modality Medical Imaging Group, TechMed Center, University of Twente, Enschede, the Netherlands. Electronic address: vascularsurgery@rijnstate.nl.

PMID: 37734570
DOI: 10.1016/j.jvs.2023.09.019

Abstract

Objective: Type II endoleak is the most frequent complication after endovascular abdominal aneurysm repair. Polytetrafluoroethylene and polyester (PE) are the two most commonly used graft materials in endovascular aneurysm repair (EVAR) devices. Biological properties of the material might influence the appearance and persistence of type II endoleak (T2EL). Therefore, the aim of this study was to evaluate potential differences in the prevalence of T2EL after EVAR between polytetrafluoroethylene (PTFE) and PE endografts in patients electively treated for an infrarenal abdominal aortic aneurysm.

Methods: A single-center, retrospective, observational study was conducted between January 2011 and January 2022. Preoperative, procedural, and follow-up data were derived from electronic health records. Imaging included computed tomography scans, and/or duplex ultrasound examination. The primary end point was the prevalence of T2EL diagnosed within 1 year after EVAR. Secondary end points included the prevalence of T2EL throughout follow-up, early (≤30 days) and late (>30 days) T2EL, the rate of T2EL disappearance during the follow-up period, the prevalence of type I and III endoleak, and T2EL-related reinterventions.

Results: Follow-up was available for 394 patients, 245 in the PE and 149 in the PTFE group. The prevalence of T2EL diagnosed within 1 year after endovascular repair was 11.8% in the PE group and 21.5% in the PTFE group (P = .010). There was no significant difference in early (≤30 days) and late (>30 days) T2EL between groups (P = .270 and P = .311). There was no difference in the freedom from endoleak type II reinterventions between groups (P = .877).

Conclusions: The prevalence of T2EL after elective EVAR is significantly higher with the use of PTFE-based endografts compared with PE-based endografts. This difference is mostly based on T2EL diagnosed after 30 days of follow-up.

Keywords: Abdominal aortic aneurysm; EVAR; Endoleak type II; Endovascular abdominal aneurysm repair; Polyester; Polytetrafluoroethylene (PTFE).

Publication types

Observational Study

MeSH terms

Aortic Aneurysm, Abdominal* / complications
Aortic Aneurysm, Abdominal* / diagnostic imaging
Aortic Aneurysm, Abdominal* / surgery
Blood Vessel Prosthesis Implantation* / adverse effects
Endoleak / diagnostic imaging
Endoleak / epidemiology
Endoleak / etiology
Endovascular Aneurysm Repair
Endovascular Procedures* / adverse effects
Humans
Polytetrafluoroethylene
Prevalence
Retrospective Studies
Risk Factors
Treatment Outcome

Substances

Polytetrafluoroethylene