Le Trong Binh, Park Keun-Myoung, Jeon Yong Sun, Hong Kee Chun, Cho Soon Gu
Endovascular Training Center, Inha University Hospital, Inha University School of Medicine, 7-206 Sinheung-dong 3-ga, Jung-gu, Incheon, Republic of Korea.
Department of Vascular Surgery, Inha University Hospital, Inha University School of Medicine, 7-206 Sinheung-dong 3-ga, Jung-gu, Incheon, Republic of Korea.
J Vasc Interv Radiol. 2018 Feb;29(2):203-209. doi: 10.1016/j.jvir.2017.09.023. Epub 2017 Dec 14.
To identify prevalence and evaluate outcomes of delayed endoleak (DEL) compared with early endoleak (EEL) after endovascular aortic aneurysm repair (EVAR).
Data of 164 patients who underwent elective EVAR at a single center were retrospectively analyzed. DEL was defined as any type of endoleak that was first detected ≥ 12 months after EVAR. Patients who had < 1 year of follow-up were excluded. Endoleak was classified into a more aggressive category if a patient had > 1 type of endoleak. Analysis included 81 patients (82.7% male). Mean age was 73.1 years ± 9.3. Median follow-up duration was 43 months (range, 12-135 months).
Endoleak was present in 32 patients (39.5%), including 21 EEL (25.9%) and 11 DEL (13.6%). DEL consisted of 2 type I, 5 type II, 1 type III, and 3 type V (endotension). Median time to detection was 45 months (range, 15-60 months), and median follow-up duration was 62 months (range, 37-104 months). Compared with EEL, DEL had larger aneurysm diameters and higher rates of non-type II endoleak and reintervention. Type II DEL also required more reintervention procedures than type II EEL.
DEL had a noteworthy incidence and occurred late after EVAR. It predominantly consisted of non-type II endoleak and appeared to have more reinterventions than EEL. Meticulous long-term imaging surveillance to identify and manage DEL is critical.
确定血管腔内主动脉瘤修复术（EVAR）后延迟内漏（DEL）的发生率，并与早期内漏（EEL）的结果进行评估比较。
回顾性分析在单一中心接受择期EVAR的164例患者的数据。DEL定义为在EVAR后≥12个月首次检测到的任何类型的内漏。随访时间<1年的患者被排除。如果患者有>1种类型的内漏，则将内漏分类为更具侵袭性的类别。分析纳入81例患者（男性占82.7%）。平均年龄为73.1岁±9.3岁。中位随访时间为43个月（范围12 - 135个月）。
32例患者（39.5%）存在内漏，包括21例EEL（25.9%）和11例DEL（13.6%）。DEL包括2例I型、5例II型、1例III型和3例V型（内张力）。检测的中位时间为45个月（范围15 - 60个月），中位随访时间为62个月（范围37 - 104个月）。与EEL相比，DEL的动脉瘤直径更大，非II型内漏和再次干预的发生率更高。II型DEL也比II型EEL需要更多的再次干预手术。
DEL发生率值得关注，且发生在EVAR术后较晚时间。它主要由非II型内漏组成，似乎比EEL有更多的再次干预。细致的长期影像学监测以识别和处理DEL至关重要。
