Publication: A systematic review of the current status of interventions for type II endoleak after EVAR for abdominal aortic aneurysms
Issued Date
2021-11-01
Resource Type
ISSN
17439159
17439191
17439191
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2-s2.0-85117194344
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Mahidol University
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SCOPUS
Bibliographic Citation
International Journal of Surgery. Vol.95, (2021)
Suggested Citation
Marethania M. Akmal, Dara R. Pabittei, Tossapol Prapassaro, Raden Suhartono, Frans L. Moll, Joost A. van Herwaarden A systematic review of the current status of interventions for type II endoleak after EVAR for abdominal aortic aneurysms. International Journal of Surgery. Vol.95, (2021). doi:10.1016/j.ijsu.2021.106138 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77720
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Title
A systematic review of the current status of interventions for type II endoleak after EVAR for abdominal aortic aneurysms
Abstract
Objective: To study the mid- and long-term outcomes of type II endoleak treatment after EVAR and the technical aspects of different techniques to exclude endoleaks which different embolic agents. Methods: A systematic review was performed using the approach recommended by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for meta-analyses of interventional studies. The comprehensive search was conducted using the following database: MEDLINE, EMBASE, and the Cochrane Library. Patient characteristic, intervention approaches, embolic agents, and results at mid and long term follow up were studied. Results: A total of 6 studies corresponding to a total of 141 patients fulfilled the inclusion criteria with a mean age of 73–78.6 years and a mean duration of follow up varying from 25 to 42 months. There were different techniques for embolization used (translumbar, transarterial, and transcaval approach) with various types of embolic agents. In all studies, the indication for embolization of the type II endoleaks was sac enlargement of more than 5 mm. A wide range of technical success rate was reported regardless of the intervention strategy being used (17,6%–100%). The overall technical success rate of all studies was 62%. Conclusion: This systematic review shows that there is a wide variety of techniques to exclude a persistent type II endoleak. Different kinds of embolic agents have be used. Due to a lack of peer reviewed data on longterm follow-up, it was not possible to come to recommendations what treatment would be the best for a durable exclusion of a persistent type II endoleak after an initially successful EVAR. There remains an urgent need for proper executed studies, either randomized or with close observation in relation to longer follow-up.