Abstract
Type 2 endoleak has been proved not to significantly increase the risk of aneurysm
rupture. However, it is associated with aneurysm enlargement and may require secondary
interventions. Its role has been widely investigated, but a definitive consensus about
its management has still not been obtained. We performed a retrospective, single-center
observational study that investigates the incidence of type 2 endoleak and its implications
in the long-term follow-up in all the patients who underwent endovascular aortic repair
(EVAR) for abdominal aortic aneurysm from 2011 to 2016 at our institution. A total
of 216 patients who underwent EVAR during the specified time period were enrolled,
and 85 of them (39%) developed type 2 endoleak in their follow-up. Thirty-one of the
patients who developed type 2 endoleak faced an aneurysm sac growth > 10 mm and required
secondary intervention. Only nine of them showed resolution of the leak. In the long-term
follow-up, patients who developed type 2 endoleak after EVAR did not show a significantly
increased mortality compared with those who did not, but some of them required late
open conversion due to aneurysm sac enlargement and some other developed a secondary
type 1 endoleak which required correction. The management of type 2 endoleak remains
debated, despite consensus exist regarding the need for intervention when a > 10-mm
aneurysm sac growth is observed. Further studies are necessary to better define which
are the “high-risk” type 2 endoleaks and identify the patients who would benefit more
from correction.
Keywords
abdominal aortic aneurysm - endovascular repair - aneurysm - coil embolization - endograft
placement - endovascular procedure - iliac artery disease
