Editor's choice - Type II endoleak: Conservative management is a safe strategy

D. A. Sidloff, V. Gokani, P. W. Stather, E. Choke, M. J. Bown, R. D. Sayers

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108 Citations (Scopus)


Objective: Type II endoleak is the most common complication after endovascular abdominal aortic aneurysm repair (EVAR); however, its natural history is unclear. The aim of this study was to examine the incidence and outcomes of type II endoleak, at a single institution after EVAR.  

Methods: A total of 904 consecutive patients who underwent EVAR between September 1995 and July 2013 at a single centre were entered onto a prospective database. All patients were followed up by duplex ultrasound (DUSS). Patients who developed type II endoleak were compared for preoperative demographics, mortality, and sac expansion.  

Results: A total of 175(19%) patients developed type II endoleak over a median follow-up of 3.6 years (1.5–5.9 years); 54% of type II endoleaks spontaneously resolved within 6 months (0.25–1.2 years). No difference was found in preoperative demographics or choice of endograft between the two groups. Survival was significantly higher in the group with type II endoleak (94.1% vs. 85.6%; p = .01) and this effect was most pronounced in those with late type II endoleaks (97.7% vs. 85.6% p = .004). No difference was seen in aneurysm-related mortality or rate of type I endoleak between the two groups. Freedom from sac expansion (>5 mm from preoperative diameter) was significantly lower in the group of patients with type II endoleak (82.5% vs. 93.2%, p = .0001); however, at a threshold of >10 mm from preoperative diameter no difference was seen.  

Conclusions: Patients with isolated type II endoleak demonstrate equivalent aneurysm-related mortality and an improved survival.
Original languageEnglish
Pages (from-to)391-399
Number of pages9
JournalEuropean Journal of Vascular and Endovascular Surgery
Issue number4
Publication statusPublished - Oct 2014

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