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Nature and significance of endoleaks and endotension: summary of opinions expressed at an international conference

Veith, Frank J; Baum, Richard A; Ohki, Takao; Amor, Max; Adiseshiah, Mohan; Blankensteijn, Jan D; Buth, Jacob; Chuter, Timothy A M; Fairman, Ronald M and Gilling-Smith, Geoffrey, et al. (2002) In Journal of Vascular Surgery 35(5). p.1029-1035
Abstract
OBJECTIVE: Endoleaks and endotension are critically important complications of some endovascular aortic aneurysm repairs (EVARs). For the resolution of controversial issues and the determination of areas of uncertainty relating to these complications, a conference of 27 interested leaders was held on November 20, 2000. METHODS: These 27 participants (21 vascular surgeons, five interventional radiologists, one cardiologist) had previously answered 40 key questions on endoleaks and endotension. At the conference, these 40 questions and participant answers were discussed and in some cases modified to determine points of agreement (consensus), near consensus (prevailing opinion), or disagreement. RESULTS: Conference discussion added two... (More)
OBJECTIVE: Endoleaks and endotension are critically important complications of some endovascular aortic aneurysm repairs (EVARs). For the resolution of controversial issues and the determination of areas of uncertainty relating to these complications, a conference of 27 interested leaders was held on November 20, 2000. METHODS: These 27 participants (21 vascular surgeons, five interventional radiologists, one cardiologist) had previously answered 40 key questions on endoleaks and endotension. At the conference, these 40 questions and participant answers were discussed and in some cases modified to determine points of agreement (consensus), near consensus (prevailing opinion), or disagreement. RESULTS: Conference discussion added two modified questions for a total of 42 key questions for the participants. Interestingly, consensus was reached on the answers to 24 of 42 or 57% of the questions, and near consensus was reached on 14 of 42 or 33% of the questions. Only with the answers to four of 42 or 10% of the questions was there persistent controversy or disagreement. CONCLUSION: The current endoleak classification system with some important modifications is adequate. Types I and II endoleak occur after 0 to 10% and 10% to 25% of EVARs, respectively. Many (30% to 100%) type II endoleaks will seal and have no detrimental effect, which never or rarely occurs with type I endoleaks. Not all endoleaks can be visualized with any technique, and increased pressure (endotension) can be transmitted through clot. Aneurysm pulsatility after EVAR correlates poorly with endoleaks and endotension. An enlarging aneurysm after EVAR mandates surgical or interventional treatment. These and other conclusions will help to resolve controversy and aid in the management of these vexing complications and should also point the way to future research in this field. (Less)
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Contribution to journal
publication status
published
subject
in
Journal of Vascular Surgery
volume
35
issue
5
pages
1029 - 1035
publisher
Mosby
external identifiers
  • pmid:12021724
  • scopus:19044368230
ISSN
1097-6809
DOI
10.1067/mva.2002.123095
language
English
LU publication?
no
id
a8aa1a61-66b4-41cb-8eba-28f25c73be97 (old id 1123855)
date added to LUP
2008-06-03 14:53:49
date last changed
2017-12-10 04:25:59
@article{a8aa1a61-66b4-41cb-8eba-28f25c73be97,
  abstract     = {OBJECTIVE: Endoleaks and endotension are critically important complications of some endovascular aortic aneurysm repairs (EVARs). For the resolution of controversial issues and the determination of areas of uncertainty relating to these complications, a conference of 27 interested leaders was held on November 20, 2000. METHODS: These 27 participants (21 vascular surgeons, five interventional radiologists, one cardiologist) had previously answered 40 key questions on endoleaks and endotension. At the conference, these 40 questions and participant answers were discussed and in some cases modified to determine points of agreement (consensus), near consensus (prevailing opinion), or disagreement. RESULTS: Conference discussion added two modified questions for a total of 42 key questions for the participants. Interestingly, consensus was reached on the answers to 24 of 42 or 57% of the questions, and near consensus was reached on 14 of 42 or 33% of the questions. Only with the answers to four of 42 or 10% of the questions was there persistent controversy or disagreement. CONCLUSION: The current endoleak classification system with some important modifications is adequate. Types I and II endoleak occur after 0 to 10% and 10% to 25% of EVARs, respectively. Many (30% to 100%) type II endoleaks will seal and have no detrimental effect, which never or rarely occurs with type I endoleaks. Not all endoleaks can be visualized with any technique, and increased pressure (endotension) can be transmitted through clot. Aneurysm pulsatility after EVAR correlates poorly with endoleaks and endotension. An enlarging aneurysm after EVAR mandates surgical or interventional treatment. These and other conclusions will help to resolve controversy and aid in the management of these vexing complications and should also point the way to future research in this field.},
  author       = {Veith, Frank J and Baum, Richard A and Ohki, Takao and Amor, Max and Adiseshiah, Mohan and Blankensteijn, Jan D and Buth, Jacob and Chuter, Timothy A M and Fairman, Ronald M and Gilling-Smith, Geoffrey and Harris, Peter L and Hodgson, Kim J and Hopkinson, Brian R and Ivancev, Krassi},
  issn         = {1097-6809},
  language     = {eng},
  number       = {5},
  pages        = {1029--1035},
  publisher    = {Mosby},
  series       = {Journal of Vascular Surgery},
  title        = {Nature and significance of endoleaks and endotension: summary of opinions expressed at an international conference},
  url          = {http://dx.doi.org/10.1067/mva.2002.123095},
  volume       = {35},
  year         = {2002},
}