Analysis And Treatment Of Risk Factors Of Type I Endoleak After Endovascular Aneurysm Repair

Objective: To analyze the risk factors and treatment methods of type Ia endoleak after endovascular aneurysm repair(EVAR).Methods: Retrospective analysis of 179 patients with abdominal aortic aneurysm and abdominal aortic endovascular repair in our hospital from June 2012 to December 2018.Follow-up follow-up for early and mid-term complications and observation of type Ia after EVAR Leakage occurred.Collect clinical data(including preoperative and postoperative CTA and DSA),analysis of neck angle,neck length,neck diameter and tumor morphology,maximum transverse diameter of the tumor,type of stent,and type Ia endoleak Relationship and symptomatic treatment.Results: A total of 179 cases were diagnosed as abdominal aortic aneurysm by abdominal aortic CT angiography and three-dimensional reconstruction.Among them,8 patients underwent preoperative diagnosis of abdominal aortic aneurysm rupture,EVAR treatment in emergency department,and the remaining 171 patients were elective.Surgical cases.11 patients(6.14%)died during the perioperative period,and the remaining 168 cases were successfully operated.After the main stent was released,60 cases(33.52%)of type Ia leakage occurred.55 cases of proximal balloon dilatation were reduced,but there were still internal leakage.Five cases were covered with stent graft and the internal leakage disappeared.After 1-36 months of follow-up,52 cases of endoleak disappeared gradually,3 cases persisted due to endoleak,the tumor continued to expand,and postoperative intervention(5.0%),1 case of aortic extension stent(CUFF)Two interventions and two open interventions were performed.After treatment,the endoleak disappeared and is still being followed up.Conclusion: The occurrence of type Ia endoleak is related to the angle of the neck,the length,the degree of calcification of the neck,the complex shape of the neck,the type of the stent,etc.The type Ia endoleak with small internal leakage can be closed by thrombus formation.No special treatment is required;for type Ia endoleaks with large internal leakage and continuous expansion of the tumor,it is necessary to intervene again.