Type II endoleak after endoaortic graft implantation: Diagnosis with helical CT arteriography

Victoria Chernyak, Alla M. Rozenblit, Michael Patlas, Jacob Cynamon, Zina J. Ricci, Mitchell P. Laks, Frank J. Veith

Research output: Contribution to journalReview article

20 Scopus citations

Abstract

Purpose: To retrospectively assess endoleak shapes and locations, within aneurysms to differentiate type II from type I and type III endoleaks. Materials and Methods: The institutional review board granted an exemption for this HIPAA-compliant study; patient informed consent was not required. A retrospective review of arterial phase helical computed tomographic (CT) studies and medical records was performed for 39 patients (29 men, 10 women; age range, 60-89 years; mean, 78.5 years) who had an endoleak after endoaortic graft implantation for treatment abdominal aortic aneurysm and who subsequently underwent angiography (n = 25), surgery (n = 8), or long-term follow-up (n = 6) to classify their endoleak into a specific type. At CT, endoleak shape (tubular or nontubular) and location (central or peripheral) were recorded. An endoleak was classified as type II if it contained a peripheral tubular component (PTC) near the aortic wall, with or without an identifiable feeding vessel. Endoleaks without these features were classified as type I or III. The Fisher exact test was used to assess associations between CT findings and endoleak type. Results: There were 22 type II and 17 type I or III endoleaks. CT enabled correct identification of 22 (100%) of 22 type II endoleaks, all of which contained a PTC. Of 17 type I or III endoleaks, only two (12%) contained a PTC and were misclassified as type II endoleaks; the remaining 15 (88%) were correctly classified. Overall, CT enabled correct identification of endoleaks as type II or type I or III in 37 (95%) of 39 patients. PTCs were significantly more common (P < .001) in type II than in type I or III endoleaks, with a sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of 100%, 88.2%, 94.9%, 100%, and 91.7%, respectively. Conclusion: A PTC is a statistically significant predictor of type II endoleak in most patients.

Original languageEnglish (US)
Pages (from-to)885-893
Number of pages9
JournalRADIOLOGY
Volume240
Issue number3
DOIs
StatePublished - Sep 1 2006

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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