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Purpose <p>To evaluate the occurrence of periaortic inflammation, including abscess formation, as a complication following endoleak repair after endovascular aortic repair.</p> Materials and methods <p>This retrospective single-center study analyzed 88 EVAR revisions for endoleak treatment performed in 59 patients between 2015 and 2025. Patients underwent one to three revision procedures. Endoleaks were classified by type, and treatment was performed via transarterial access or direct sac puncture with a posterior/translumbar access route. Embolization materials for type II endoleaks included n-butyl-2-cyanoacrylate, ethylene vinyl alcohol, and coils, while stent-graft extensions and transmural fixation were used for type I and III endoleaks.</p> Results <p>Of the 59 patients, 38 (64.4%) underwent one revision, 13 (22.0%) two revisions, and 8 (13.6%) three revisions. Treated endoleaks included type I (19.3%), type II (77.3%), type III (2.3%), and combined type II/III (1.1%). A total of 73 procedures (83.0%) were performed via transarterial access and 15 (17.0%) via direct sac puncture. Follow-up CT identified 6 cases of periaortic inflammation after type II endoleak repair, presenting with soft tissue mantle, fat stranding, or abscess formation. Symptom onset ranged from 33 to 108&#xa0;days after the most recent intervention. No significant association was found between periaortic inflammation and access route or embolic material.</p> Conclusion <p>Periaortic inflammation and abscess formation are possible severe complications after endoleak repair following endovascular aortic repair. To date, these inflammatory changes have not been described systematically in the literature and warrant further investigation.</p>

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Periaortic inflammation after endoleak repair: a risk to watch

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月27日

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  • Marilia Bernadette Voigt,
  • Alexander Böhner,
  • Mohammed Bahaaeldin,
  • Julia Wagenpfeil,
  • Tatjana Dell,
  • Alexander Isaak,
  • Claus-Christian Pieper,
  • Julian A. Luetkens,
  • Patrick A. Kupczyk,
  • Carsten Meyer,
  • Alexander Kania,
  • Daniel Kuetting

摘要

Purpose

To evaluate the occurrence of periaortic inflammation, including abscess formation, as a complication following endoleak repair after endovascular aortic repair.

Materials and methods

This retrospective single-center study analyzed 88 EVAR revisions for endoleak treatment performed in 59 patients between 2015 and 2025. Patients underwent one to three revision procedures. Endoleaks were classified by type, and treatment was performed via transarterial access or direct sac puncture with a posterior/translumbar access route. Embolization materials for type II endoleaks included n-butyl-2-cyanoacrylate, ethylene vinyl alcohol, and coils, while stent-graft extensions and transmural fixation were used for type I and III endoleaks.

Results

Of the 59 patients, 38 (64.4%) underwent one revision, 13 (22.0%) two revisions, and 8 (13.6%) three revisions. Treated endoleaks included type I (19.3%), type II (77.3%), type III (2.3%), and combined type II/III (1.1%). A total of 73 procedures (83.0%) were performed via transarterial access and 15 (17.0%) via direct sac puncture. Follow-up CT identified 6 cases of periaortic inflammation after type II endoleak repair, presenting with soft tissue mantle, fat stranding, or abscess formation. Symptom onset ranged from 33 to 108 days after the most recent intervention. No significant association was found between periaortic inflammation and access route or embolic material.

Conclusion

Periaortic inflammation and abscess formation are possible severe complications after endoleak repair following endovascular aortic repair. To date, these inflammatory changes have not been described systematically in the literature and warrant further investigation.