PMID- 31394212
OWN - NLM
STAT- MEDLINE
DCOM- 20201019
LR  - 20210110
IS  - 1615-5947 (Electronic)
IS  - 0890-5096 (Print)
IS  - 0890-5096 (Linking)
VI  - 66
DP  - 2020 Jul
TI  - The Spatial Morphology of Intraluminal Thrombus Influences Type II Endoleak after 
      Endovascular Repair of Abdominal Aortic Aneurysms.
PG  - 77-84
LID - S0890-5096(19)30545-X [pii]
LID - 10.1016/j.avsg.2019.05.050 [doi]
AB  - INTRODUCTION: Type 2 endoleaks (T2Es) after endovascular repair (EVAR) of 
      abdominal aortic aneurysm (AAA) can lead to sac expansion or failure of sac 
      regression, and often present as a management dilemma. The intraluminal thrombus 
      (ILT) may influence the likelihood of endoleaks after EVAR and can be 
      characterized using routine preoperative imaging. We examined the relationship 
      between preoperative spatial morphology of ILT and the incidence of postoperative 
      T2E. METHODS: All patients who underwent EVAR at the John Radcliffe Hospital 
      (Oxford, UK) were prospectively entered in a clinical database. Computed 
      tomography angiograms (CTAs) were performed as part of routine clinical care. The 
      ILT morphology of each patient was determined using the preoperative CTA. 
      Arterial phase cross-sectional images of the AAA were analyzed according to the 
      presence and morphology of the thrombus in each quadrant. The overall ILT 
      morphology was defined by measurements obtained over a 4-cm segment of the AAA. 
      The diagnosis of T2Es during EVAR surveillance was confirmed by CTAs. The 
      relation between the ILT morphology and T2E was assessed using logistic 
      regression. RESULTS: Between September 2009 and July 2016, 271 patients underwent 
      EVAR for infrarenal AAAs (male: 241, age = 79 +/- 7). The ILT was present in 265 
      (98%) of AAAs. Mean follow-up was 1.9 +/- 1.6 years. The T2E was observed in 77 
      cases. Sixty-one percent of T2Es were observed within the first week after 
      surgery. The T2E was observed in 50% (3/6) of cases without the ILT (no-ILT). 
      Compared with no-ILT, the presence of circumferential or posterolateral ILTs was 
      protective from T2Es (odds ratio = 0.33 and 0.37; P = 0.002 and P = 0.047, 
      respectively). CONCLUSIONS: The spatial ILT morphology on routine preoperative 
      CTA imaging can be a biomarker for post-EVAR T2Es. ILTs that cover the 
      posterolateral aspects of the lumen, or circumferential ILTs, are protective of 
      T2Es. This information can be useful in the preoperative planning of EVARs.
CI  - Copyright (c) 2019 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Whaley, Zachary L
AU  - Whaley ZL
AD  - Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; 
      Division of Vascular Surgery and Endovascular Therapy, University of Alabama at 
      Birmingham, Birmingham, AL.
FAU - Cassimjee, Ismail
AU  - Cassimjee I
AD  - Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
FAU - Novak, Zdenek
AU  - Novak Z
AD  - Division of Vascular Surgery and Endovascular Therapy, University of Alabama at 
      Birmingham, Birmingham, AL.
FAU - Rowland, David
AU  - Rowland D
AD  - Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
FAU - Lapolla, Pierfrancesco
AU  - Lapolla P
AD  - Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
FAU - Chandrashekar, Anirudh
AU  - Chandrashekar A
AD  - Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
FAU - Pearce, Benjamin J
AU  - Pearce BJ
AD  - Division of Vascular Surgery and Endovascular Therapy, University of Alabama at 
      Birmingham, Birmingham, AL.
FAU - Beck, Adam W
AU  - Beck AW
AD  - Division of Vascular Surgery and Endovascular Therapy, University of Alabama at 
      Birmingham, Birmingham, AL.
FAU - Handa, Ashok
AU  - Handa A
AD  - Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
FAU - Lee, Regent
AU  - Lee R
AD  - Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK. 
      Electronic address: regent.lee@nds.ox.ac.uk.
CN  - Oxford Abdominal Aortic Aneurysm Study
CN  - Oxford Regional Vascular Services
LA  - eng
PT  - Journal Article
DEP - 20190805
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Aneurysm, Abdominal/diagnostic imaging/*surgery
MH  - *Aortography
MH  - Blood Vessel Prosthesis Implantation/*adverse effects
MH  - *Computed Tomography Angiography
MH  - Databases, Factual
MH  - Endoleak/diagnostic imaging/*etiology
MH  - Endovascular Procedures/*adverse effects
MH  - England
MH  - Female
MH  - Humans
MH  - Male
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Thrombosis/*diagnostic imaging
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC7327520
FIR - Peto, Tim
IR  - Peto T
FIR - Finney, John
IR  - Finney J
FIR - Darby, Chris R
IR  - Darby CR
FIR - Halliday, Alison
IR  - Halliday A
FIR - Hands, Linda J
IR  - Hands LJ
FIR - Howard, Dominique P J
IR  - Howard DPJ
FIR - Lintott, Patrick
IR  - Lintott P
FIR - Magee, Tim R
IR  - Magee TR
FIR - Northeast, Andrew
IR  - Northeast A
FIR - Perkins, Jeremy
IR  - Perkins J
FIR - Sideso, Ediri
IR  - Sideso E
FIR - Wilton, Emma
IR  - Wilton E
FIR - Handa, Ashok
IR  - Handa A
EDAT- 2019/08/09 06:00
MHDA- 2020/10/21 06:00
PMCR- 2020/07/01
CRDT- 2019/08/09 06:00
PHST- 2019/03/20 00:00 [received]
PHST- 2019/05/20 00:00 [revised]
PHST- 2019/05/24 00:00 [accepted]
PHST- 2019/08/09 06:00 [pubmed]
PHST- 2020/10/21 06:00 [medline]
PHST- 2019/08/09 06:00 [entrez]
PHST- 2020/07/01 00:00 [pmc-release]
AID - S0890-5096(19)30545-X [pii]
AID - 10.1016/j.avsg.2019.05.050 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2020 Jul;66:77-84. doi: 10.1016/j.avsg.2019.05.050. Epub 2019 Aug 
      5.