Late intervention for type II endoleak is not determined by early sac diameter or volume changes after EVAR

FIGURE 1.

Diameter and volume changes in patients with (n = 27) and without (n = 76) later intervention for type II endoleak

Diameter / volume changes between 3 months and 1 year of follow-up
	no intervention	intervention	P-value
Ax diameter absolute change (mm)	−0.22 (min −9.0; max 6.0)	−0.48 (min −20.0; max 5.0)	0.37
Ax diameter relative change (%)	−0.43 (min −14.3; max 8.7)	−0.74 (min −30.8; max 7.8)	0.37
Per diameter absolute change (mm)	0.05 (min −10.0; max 7.0)	−0.85 (min −20.0; max 5.0)	0.91
Per diameter relative change (%)	0.15 (min −15.6; max 10.4)	−1.3 (min −30.8; max 8.2)	0.79
Volume absolute change (cm3)	−2.22 (min −67.0; max 55.0)	−10.89 (min −169.0; max 33.0)	0.96
Volume relative change (%)	−1.4 (min −28.6; max 14.2)	−2.2 (min −10.3; max 7.4)	0.92

Agreement between axial (Ax)/perperdicular (Per) sac diameter and sac volume

Diameter	statistic volume change < 12%	volume change > 12%
Ax diameter
< 5 mm change	n/N (%) 93/95 (97.9%)	8/8 (100%)
> 5 mm change	n/N (%) 2/95 (2.1%)	0/8 (0%)
Per diameter
< 5 mm change	n/N (%) 92/95 (96.8%)	7/8 (87.5%)
> 5 mm change	n/N (%) 3/95 (3.2%)	1/8 (12.5%)

Patients’ and procedural characteristics

Clinical characteristic
Age (years)
Mean age	74 (min 58; max 92)
Sex
Female	n = 5 (5%)
Male	n = 98 (95%)
Risk factors for atherosclerotic aortic disease according to Doyle et al.11
ASA-classification
ASA 1	n = 4 (3.8%)
ASA 2	n = 18 (17.3%)
ASA 3	n = 75 (72.1%)
ASA 4	n = 6 (5.7%)
Cardiac disease	n = 49 (47.1%)
Carotid disease	n = 16 (15.4%)
Hyperlipidemia	n = 84 (80.7%)
Renal insufficiency	n = 43 (41.3%)
Diabetes mellitus	n = 26 (25%)
Arterial hypertension
Controlled	n = 83 (79.8%)
Uncontrolled	n = 8 (7.7%)
Pulmonary disease	n = 38 (36.5%)
Smoking
Active	n = 9 (8.6%)
Previous	n = 74 (71.1%)
Stent-graft for EVAR
Excluder	n = 41 (40%)
Endurant	n = 20 (19%)
Ovation	n = 23 (22%)
Zenith	n = 13 (13%)
Quantum	n = 4 (4%)
Other	n = 2 (2%)

Correlation between axial / perpendicular diameter and volume at 3 months and 1 year

At 3 months of follow-up
Association of sac volume (cm3) with	Rho	95% CI	P-value
Axial diameter (mm)	0.89	(0.84; 0.92)	< 0.0001
Perpendicular diameter (mm)	0.90	(0.86; 0.93)	< .0001
At 1 year of follow-up
Association of sac volume (cm3) with
Axial diameter (mm)	0.91	(0.87; 0.93)	< 0.0001
Perpendicular diameter (mm)	0.92	(0.89; 0.95)	< 0.0001
Association of volume (absolute changes) (cm3) with
Axial diameter (mm)	0.74	(0.64; 0.82)	< 0.0001
Perpendicular diameter (mm)	0.57	(0422; 0.69)	< 0.0001
Association of volume (relative changes) (cm3) with
Axial diameter (mm)	0.83	(076; 0.89)	< 0.0001
Perpendicular diameter (mm)	0.76	(0.66; 083)	< 0.0001

Diameter and volume measurements of the excluded aneurysm sac of 103 patients

Maximum diameter / volume
Axial diameter (mm) at 3 months	63.7 (min 36.0; max 138.0)
Axial diameter (mm) at 1 year	63.4 (min 37.0; max 133.0)
Perpendicular diameter (mm) at 3 months	63.2 (min 35.0; max 141.0)
Perpendicular diameter (mm) at 1 year	63.0 (min 36.0; max 142.0)
Volume aneurysm sac (cm3) at 3 months	213.8 (min 67.0; max 1316.0)
Volume aneurysm sac (cm3) at 1 year	209.3 (min 72.0; max 1147.0)
Axial diameter absolute change (mm)	−0.3 (min −20.0; max −7.0)
Axial diameter relative change (%)	−0.51 (min −30.8; max 8.7)
Perpendicular diameter absolute change (mm)	−0.2 (min −20.0; max −7.0)
Perpendicular diameter relative change (%)	−0.2 (min −30.8; max 10.5)
Volume absolute change (cm3)	−4.5 (min −169.0; max −55.0)
Volume relative change (%)	−1.6 (min −50.7; max 20.8)