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Purpose <p>This study aimed to evaluate the correlation between longitudinal changes in the sac size and proximal sealing length in patients who developed sac enlargement with type II endoleak (T2EL) after endovascular aneurysm repair (EVAR).</p> Methods <p>This retrospective, single-center study included patients who developed sac enlargement (≥ 5&#xa0;mm increase) with T2EL after elective EVAR for an infrarenal abdominal aortic aneurysm between 2007 and 2023. The endpoints included the correlation between changes in the sac size and proximal sealing length, shortening of proximal sealing (decrease to a length of &lt; 10&#xa0;mm), secondary type Ⅰa endoleak (T1aEL), and aneurysm rupture.</p> Results <p>A total of 46 patients were included, with a median follow-up period of 6.2 years. A linear regression analysis demonstrated a moderate inverse correlation between changes in the sac size and the proximal sealing length. The cumulative incidences of shortening of proximal sealing and secondary T1aEL at 7 years were 24% and 10%, respectively, and a total of six (13%) patients required reintervention for secondary T1aEL. Two late AAA ruptures were observed. However, no aneurysm-related deaths occurred during the follow-up period.</p> Conclusions <p>In patients who develop sac enlargement with T2EL, proximal sealing length tends to decrease over time, which may contribute to secondary T1aEL after EVAR.</p>

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Proximal sealing length change inversely correlates with the sac size change in patients with sac enlargement associated with type Ⅱ endoleak after endovascular aneurysm repair

  • 期刊论文

  • 发表日期：

    2026年7月17日

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  • Shinichiro Yoshino,
  • Koichi Morisaki,
  • Daichi Ito,
  • Mitsuru Nakanishi,
  • Yusuke Fujioka,
  • Kohei Ueno,
  • Go Kinoshita,
  • Kentaro Inoue,
  • Tomoharu Yoshizumi

摘要

Purpose

This study aimed to evaluate the correlation between longitudinal changes in the sac size and proximal sealing length in patients who developed sac enlargement with type II endoleak (T2EL) after endovascular aneurysm repair (EVAR).

Methods

This retrospective, single-center study included patients who developed sac enlargement (≥ 5 mm increase) with T2EL after elective EVAR for an infrarenal abdominal aortic aneurysm between 2007 and 2023. The endpoints included the correlation between changes in the sac size and proximal sealing length, shortening of proximal sealing (decrease to a length of < 10 mm), secondary type Ⅰa endoleak (T1aEL), and aneurysm rupture.

Results

A total of 46 patients were included, with a median follow-up period of 6.2 years. A linear regression analysis demonstrated a moderate inverse correlation between changes in the sac size and the proximal sealing length. The cumulative incidences of shortening of proximal sealing and secondary T1aEL at 7 years were 24% and 10%, respectively, and a total of six (13%) patients required reintervention for secondary T1aEL. Two late AAA ruptures were observed. However, no aneurysm-related deaths occurred during the follow-up period.

Conclusions

In patients who develop sac enlargement with T2EL, proximal sealing length tends to decrease over time, which may contribute to secondary T1aEL after EVAR.