Factors influencing the development of type I endoleak following endovascular aortic repair for abdominal aortic aneurysms

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Aim: This study sought to investigate possible anatomical and clinical determinants linked to the occurrence of type I endoleak after endovascular aneurysm repair (EVAR) in patients with abdominal aortic aneurysm (AAA). Material and Methods: This was a retrospective, single-center cohort study comprising 133 patients who underwent elective EVAR between 2019 and 2024. Patients were categorized according to the presence of type I endoleak (n = 28) or absence (n = 105). Baseline characteristics, comorbidities, and preoperative imaging findings were analyzed. Significant factors influencing development of type I endoleak were identified using multivariable logistic regression, and diagnostic performance was assessed with receiver operating characteristic (ROC) analysis. Results: Patients who developed type I endoleak were older (p = 0.048). They also exhibited significantly larger aortic neck diameters, greater neck angulation, shorter neck lengths, and a higher prevalence of neck calcification. Multivariable analysis confirmed neck diameter (OR = 1.240, p = 0.001), neck length (OR = 0.871, p = 0.002), neck angulation (OR = 1.077, p = 0.007), and calcification (p = 0.041) as significant predictive factors. ROC analysis identified 26.5 mm and 58.5° as optimal cut-off values for neck diameter and angulation, respectively. Conclusion: Adverse proximal neck morphology plays a key role in the development of type I endoleak following EVAR. Careful preoperative assessment of these anatomical features may enhance risk stratification and improve EVAR outcomes.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.