Long-term Clinical Outcomes and Predictors of Type-III Endoleak in a Large Cohort of Patients Treated With Anatomically Fixed Stent Grafts Over 20 Years.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Long-term Clinical Outcomes and Predictors of Type-III Endoleak in a Large Cohort of Patients Treated With Anatomically Fixed Stent Grafts Over 20 Years.
Συγγραφείς:	Leone N; Department of Vascular Surgery, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, Modena, Italy., Andreoli F; Department of Vascular Surgery, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, Modena, Italy., Baresi GF; Department of Vascular Surgery, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, Modena, Italy., Ferri A; Department of Vascular Surgery, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, Modena, Italy., Bartolotti LAM; Department of Vascular Surgery, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, Modena, Italy., Saitta GM; Department of Vascular Surgery, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, Modena, Italy., Silingardi R; Department of Vascular Surgery, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, Modena, Italy., Gennai S; Department of Vascular Surgery, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, Modena, Italy.
Πηγή:	Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists [J Endovasc Ther] 2026 Aug; Vol. 33 (4), pp. 1893-1903. Date of Electronic Publication: 2025 Feb 21.
Τύπος έκδοσης:	Journal Article; Comparative Study
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: Sage Publications Country of Publication: United States NLM ID: 100896915 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1545-1550 (Electronic) Linking ISSN: 15266028 NLM ISO Abbreviation: J Endovasc Ther Subsets: MEDLINE
Imprint Name(s):	Publication: 2015- : Thousand Oaks, CA : Sage Publications Original Publication: Phoenix, AZ : The Society, c2000-
Ιατρικοί όροι (MeSH):	Endoleak/epidemiology , Endoleak/diagnostic imaging , Endoleak/mortality , Endoleak/etiology , Aortic Aneurysm, Abdominal/surgery , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortic Aneurysm, Abdominal/mortality , Endovascular Aneurysm Repair/adverse effects , Endovascular Aneurysm Repair/instrumentation , Endovascular Aneurysm Repair/mortality , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/instrumentation , Blood Vessel Prosthesis Implantation/mortality , Endovascular Procedures/adverse effects , Endovascular Procedures/instrumentation , Endovascular Procedures/mortality , Blood Vessel Prosthesis* , Stents*, Humans ; Risk Factors ; Time Factors ; Female ; Aged ; Retrospective Studies ; Prosthesis Design ; Male ; Incidence ; Aged, 80 and over ; Risk Assessment ; Treatment Outcome
Περίληψη:	Objective: To assess the incidence, outcomes, and predictors of type III endoleaks (TIIIELs) in patients treated with different generations of Endologix unibody devices for abdominal aortic aneurysm (AAA). Methods: Patients treated with unibody endografts between 1999 and 2020 in a single unit were prospectively enrolled, retrospectively analyzed, and stratified according to device generation. The primary outcome was the incidence of TIIIEL in patients treated with unibody devices. Secondary outcomes included: (1) TIIIEL incidence among the different device generations; (2) comparison of type IIIa (TIIIaELs) and type IIIb endoleaks (TIIIbELs) incidence, treatment, and complications; (3) risk factor analysis for TIIIEL; (4) overall survival and survival free from TIIIEL. Results: A total of 872 patients who underwent endovascular aortic repair (EVAR) were analyzed. The cumulative incidence of TIIIEL was 4.8% (42/872). The incidence among different generations was 2.4% (10/414), 21.7% (15/69), and 4.6% (16/341), and 2.1% (1/48) for Powerlink, AFXs, AFXd, and AFX2. Freedom from TIIIEL by device generation was significantly lower in the AFXs group (p<0.001). Type III endoleaks was higher in urgent EVAR (p=0.011), large AAA (p<0.001), angulated and calcified necks (p=0.002), and when more than one modular component or non-proprietary extension was used (p<0.001). AFXs was found as independent risk factor for TIIIEL (hazard ratio [HR]=3.1, p=0.003), while the use of a single component decreased the risk (HR=0.3, p=0.005). Finally, every 10-mm increase in AAA diameter resulted in a 2-fold increase in TIIIEL risk (HR=2.0, p<0.001). Conclusion: The first generation of AFX endograft was associated with an increase in TIIIEL risk by 3.1 times, claiming a strict and careful follow-up in patients implanted with this device.Clinical ImpactThe old-generation of unibody endograft AFXs was associated with an increase in TIIIEL risk by 3.1 times. Angulated and calcified neck, large aneurysms and the use of nonproprietary graft extension were found as independent risk factors for TIIIEL. Patients implanted with these devices and with these anatomical features should be intensively monitored during follow-up.
Competing Interests:	Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Contributed Indexing:	Keywords: AAA; AFX; EVAR; Endologix; TIIIEL; endoleak
Entry Date(s):	Date Created: 20250221 Date Completed: 20260716 Latest Revision: 20260716
Update Code:	20260717
DOI:	10.1177/15266028251317910
PMID:	39981823
Βάση Δεδομένων:	MEDLINE

Περιγραφή
ISSN:	1545-1550
DOI:	10.1177/15266028251317910