A perioperative strategy for abdominal aortic aneurysm in patients with chronic renal insufficiency
To investigate the natural course of type 2 endoleaks (T2Es) and to identify the risk factors associated with a persistent T2E after endovascular aneurysm repair (EVAR). The medical records of patients who underwent EVAR for the treatment of an atherosclerotic abdominal aortic aneurysm between October 2006 and December 2011 at our institute were reviewed. T2Es were diagnosed by contrast-enhanced computed tomography within 4 weeks of EVAR, and patients were followed up at 6 and 12 months. In cases where a T2E was detected, the blood vessels responsible for the T2E were identified and statistically analyzed for their association with a persistent T2E. We identified T2Es in 111 of 469 patients within 4 weeks of undergoing EVAR. During the follow-up, 41 patients (36.9 %) showed spontaneous resolution of their T2E. The percentage of patients with a T2E was 75.4, 69.2 and 58.0 % at 6, 12 and 24 months, respectively. T2E caused by defects in multiple vessels and T2E associated with the fourth lumbar artery were identified as risk factors associated with a persistent T2E in the univariate analysis. In the multivariate analysis, T2E caused by multiple vessels was identified as the only independent risk factor for a persistent T2E. We identified T2E caused by multiple vessel failure as an independent risk factor for persistent T2E.