Fate of endoleaks after endoluminal repair of abdominal aortic aneurysms with the EVT (R) device

Objective: we aim to describe our medium-term follow-up of 20 patients with an endoleak following repair of their abdominal aortic aneurysms (AAA) usi ng the Endovascular Technologies (EVT) device. Design: the experience of one centre in a prospective multicentre phase II trial. Materials and methods: 55 patients with an endovascular repair of their AAA and at least 6 months' follow-up were reviewed. Intraoperative angiograms, next day duplex scans and computed tomography (CT) images were used to det ect endoleaks. Follow-up with CT and duplex was performed at 3, 6, 12 and 2 4 months. Persistent endoleaks at 6 months were evaluated by angiography an d treated by endovascular coiling. Results: there were three immediate conversions to open procedures. Twenty of 52 (38%) patients had an endoleak identified initially. One patient died from a myocardial infarction and three were not evident any longer by disc harge CT. Sixteen endoleaks (31%) were present at discharge. Nine resolved spontaneously by 3-6 months and seven were still persistent at 6 months (14 %). Six patients underwent coiling of their leak, all with successful radio graphic seal after 1-3 sessions. Conclusions: endoleaks are frequent after endovascular AAA repair, but the majority close spontaneously. Coiling of the leaks and radiographic seal ca rl be achieved in all cases still persistent at 6 months. Whether this meth od is clinically effective awaits further follow-up.