Diagnosis and Treatment for Endoleaks after Endovascular Repair of Abdominal Aortic Aneurysm_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GUO Facai , DAI Yuanbin.

Department of Vascular Surgery， The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China;

Corresponding author：

Keywords：

Abdominal aortic aneurysm; Endovascular repair; Endoleak

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ObjectiveTo explore the progresses of diagnosis and treatment for endoleaks after endovascular repair of abdominal aortic aneurysm (EVAR). MethodsThe literatures on studying the classification, diagnosis and management, risk factor, and treatment for the endoleaks after EVAR were reviewed and analyzed. ResultsEndoleak was a common and particular complication after EVAR and its represented persistence meant failure of the EVAR treatment. Accurate detection and classification were essential for the proper management and the treatment method for the endoleak was determined by the different source. Type Ⅰ and type Ⅲ endoleak required urgent treatment， type Ⅱ and type Ⅴ were considered less urgently but may be observed continuously. A variety of techniques including extension endografts or cuff, balloon angioplasty, bare stents, and a combination of transvascular and direct sac puncture embolization techniques were allowed to treat the vast majority of these endoleaks. ConclusionsEndoleak after EVAR is still the main clinical problem to be solved. The characters of endoleak still are not fully revealed. The diagnosis and treatment remained equivocal, which requires further study.

Citation： GUO Facai,DAI Yuanbin.. Diagnosis and Treatment for Endoleaks after Endovascular Repair of Abdominal Aortic Aneurysm. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(4): 455-461. doi: Copy

1.	Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms [J]. Ann Vasc Surg, 1991, 5(6): 491499.
2.	Lovegrove RE, Javid M, Magee TR, et al. A metaanalysis of 21 178 patients undergoing open or endovascular repair of abdominal aortic aneurysm [J]. Br J Surg, 2008, 95(6): 677684．.
3.	Rayt HS, Sutton AJ, London NJ, et al. A systematic review and metaanalysis of endovascular repair (EVAR) for ruptured abdominal aortic aneurysm [J]. Eur J Vasc Endovasc Surg, 2008, 36(5): 536544．.
4.	Sajid MS, Desai M, Haider Z, et al. Endovascular aortic aneurysm repair (EVAR) has significantly lower perioperative mortality in comparison to open repair: a systematic review [J]. Asian J Surg, 2008, 31(3): 119123．.
5.	Madden N, Baril DT, Wertz R, et al. Endovascular abdominal aortic aneurysm repair: a community hospital’s experience [J]. Vasc Endovascular Surg, 2009, 43(1): 2529.
6.	Cao P, De Rango P, Verzini F, et al. Endoleak after endovascular aortic repair: classification, diagnosis and management following endovascular thoracic and abdominal aortic repair [J]. J Cardiovasc Surg (Torino), 2010, 51(1): 5369.
7.	White GH, Yu W, May J. Endoleak－a proposed new terminology to describe incomplete aneurysm exclusion by an endoluminal graft [J]. J Endovasc Surg, 1996, 3(1): 124125.
8.	Veith FJ, Baum RA, Ohki T, et al. Nature and significance of endoleaks and endotension: summary of opinions expressed at an international conference [J]. J Vasc Surg, 2002, 35(5): 10291035.
9.	景在平, 梅志军. 主动脉夹层腔内隔绝术后内漏的处理 [J]. 中国普外基础与临床杂志, 2006, 13(6): 632．.
10.	Buth J, Laheij RJ. Early complications and endoleaks after endovascular abdominal aortic aneurysm repair: report of a multicenter study [J]. J Vasc Surg, 2000, 31(1 Pt 1): 134146．.
11.	Buth J, Harris PL, van Marrewijk C, et al. The significance and management of different types of endoleaks [J]. Semin Vasc Surg, 2003, 16(2): 95102.
12.	Buth J, Harris PL, Hobo R, et al. Neurologic complications associated with endovascular repair of thoracic aortic pathology: Incidence and risk factors. A study from the European Collaborators on Stent/Graft Techniques for Aortic Aneurysm Repair (EUROSTAR) registry [J]. J Vasc Surg, 2007, 46(6): 11031110．.
13.	Franks SC, Sutton AJ, Bown MJ, et al. Systematic review and metaanalysis of 12 years of endovascular abdominal aortic aneurysm repair [J]. Eur J Vasc Endovasc Surg, 2007, 33(2): 154171．.
14.	Chuter TA, Parodi JC, LawrenceBrown M. Management of abdominal aortic aneurysm: a decade of progress [J]. J Endovasc Ther, 2004, 11 Suppl 2: Ⅱ82Ⅱ95．.
15.	Sampaio SM, Panneton JM, Mozes GI, et al. Proximal type Ⅰ endoleak after endovascular abdominal aortic aneurysm repair: predictive factors [J]. Ann Vasc Surg, 2004, 18(6): 621628.
16.	Schurink GW, Aarts NJ, van Baalen JM, et al. Stent attachment siterelated endoleakage after stent graft treatment: An in vitro study of the effects of graft size, stent type, and atherosclerotic wall changes [J]. J Vasc Surg, 1999, 30(4): 658667．.
17.	Yamaguchi M, Sugimoto K, Zamora CA, et al. Placement of selfexpanding stents with different diameters in the porcine venous system: an experimental study [J]. J Vasc Interv Radiol, 2006, 17(1): 113119.
18.	Walschot LH, Laheij RJ, Verbeek AL. Outcome after endovascular abdominal aortic aneurysm repair: a metaanalysis [J]. J Endovasc Ther, 2002, 9(1): 8289.
19.	Greenberg RK, West K, Pfaff K, et al. Beyond the aortic bifurcation: branched endovascular grafts for thoracoabdominal and aortoiliac aneurysms [J]. J Vasc Surg, 2006, 43(5): 879886.
20.	Fan CM, Rafferty EA, Geller SC, et al. Endovascular stentgraft in abdominal aortic aneurysms: the relationship between patent vessels that arise from the aneurysmal sac and early endoleak [J]. Radiology, 2001, 218(1): 176182．.
21.	Baum RA, Carpenter JP, Cope C, et al. Aneurysm sac pressure measurements after endovascular repair of abdominal aortic aneurysms [J]. J Vasc Surg, 2001, 33(1): 3241．.
22.	Fairman RM, Carpenter JP, Baum RA, et al. Potential impact of therapeutic warfarin treatment on type Ⅱ endoleaks and sac shrinkage rates on midterm followup examination [J]. J Vasc Surg, 2002, 35(4): 679685．.
23.	Bobadilla JL, Hoch JR, Leverson GE, et al. The effect of warfarin therapy on endoleak development after endovascular aneurysm repair (EVAR) of the abdominal aorta [J]. J Vasc Surg, 2010, 52(2): 267271.
24.	Iyer VS, Mackenzie KS, Corriveau MM, et al. Reversible endotension associated with excessive warfarin anticoagulation [J]. J Vasc Surg, 2007, 45(3): 600602.
25.	Tanski W 3rd, Fillinger M. Outcomes of original and lowpermeability Gore Excluder endoprosthesis for endovascular abdominal aortic aneurysm repair [J]. J Vasc Surg, 2007, 45(2): 243249.
26.	叶红, 范占明. 腹主动脉瘤破裂的危险因素及影像学研究进展 [J]. 中国介人影像与治疗学, 2009, 6(4): 367370.
27.	Iezzi R, Cotroneo AR, Filippone A, et al. Multidetectorrow computed tomography angiography in abdominal aortic aneurysm treated with endovascular repair: evaluation of optimal timing of delayed phase imaging for the detection of lowflow endoleaks [J]. J Comput Assist Tomogr, 2008, 32(4): 609615.
28.	Schmieder GC, Stout CL, Stokes GK, et al． Endoleak after endovascular aneurysm repair: duplex ultrasound imaging is better than computed tomography at determining the need for intervention [J]. J Vasc Surg, 2009, 50(5): 10121017.
29.	Frydrychowicz A, Harloff A, Jung B, et al. Timeresolved, 3dimensional magnetic resonance flow analysis at 3 T: visualization of normal and pathological aortic vascular hemodynamics [J]. J Comput Assist Tomogr, 2007, 31(1): 915．.
30.	Alerci M, Oberson M, Fogliata A, et al. Prospective, intraindividual comparison of MRI versus MDCT for endoleak detection after endovascular repair of abdominal aortic aneurysms [J]. Eur Radiol, 2009, 19(5): 12231231.
31.	Ellozy SH, Carroccio A, Lookstein RA, et al. First experience in human beings with a permanently implantable intrasac pressure transducer for monitoring endovascular repair of abdominal aortic aneurysms [J]. J Vasc Surg, 2004, 40(3): 405412.
32.	Lorelli DR, JeanClaude JM, Fox CJ, et al. Response of plasma matrix metalloproteinase9 to conventional abdominal aortic aneurysm repair or endovascular exclusion: implications for endoleak [J]. J Vasc Surg, 2002, 35(5): 916922．.
33.	Mandziak DM, Stanley BM, Foreman RK, et al. Outcome of endoleak following endoluminal abdominal aortic aneurysm repair [J]. ANZ J Surg, 2004, 74(12): 10391042．.
34.	Fransen GA, Vallabhaneni SR Sr, van Marrewijk CJ, et al; EUROSTAR. Rupture of infrarenal aortic aneurysm after endovascular repair: a series from EUROSTAR registry [J]. Eur J Vasc Endovasc Surg, 2003, 26(5): 487493．.
35.	Hobo R, Buth J; EUROSTAR collaborators. Secondary interventions following endovascular abdominal aortic aneurysm repair using current endografts. A EUROSTAR report [J]. J Vasc Surg, 2006, 43(5): 896902.
36.	Tuerff SN, Rockman CB, Lamparello PJ, et al. Are type Ⅱ (branch vessel) endoleaks really benign? [J]. Ann Vasc Surg, 2002, 16(1): 5054.
37.	Jones JE, Atkins MD, Brewster DC, et al. Persistent type 2 endoleak after endovascular repair of abdominal aortic aneurysm is associated with adverse late outcomes [J]. J Vasc Surg, 2007, 46(1): 18．.
38.	Xenos ES, Stevens SL, Freeman MB, et al. Distribution of sac pressure in an experimental aneurysm model after endovascular repair: the effect of endoleak types Ⅰ and Ⅱ [J]. J Endovasc Ther, 2003, 10(3): 516523．.
39.	Timaran CH, Ohki T, Veith FJ, et al. Influence of type Ⅱ endoleak volume on aneurysm wall pressure and distribution in an experimental model [J]. J Vasc Surg, 2005, 41(4): 657663．.
40.	Maldonado TS, Gagne PJ. Controversies in the management of type Ⅱ “branch” endoleaks following endovascular abdominal aortic aneurysm repair [J]. Vasc Endovascular Surg, 2003, 37(1): 112.
41.	Chong CK, How TV, GillingSmith GL, et al. Modeling endoleaks and collateral reperfusion following endovascular AAA exclusion [J]. J Endovasc Ther, 2003, 10(3): 424432.
42.	Chou MM, Ke YM, Wu HC, et al. Temporary crossclamping of the infrarenal abdominal aorta during cesarean hysterectomy to control operative blood loss in placenta previa increta/percreta [J]. Taiwan J Obstet Gynecol, 2010, 49(1): 7276.
43.	Baum RA, Carpenter JP, Tuite CM, et al. Diagnosis and treatment of inferior mesenteric arterial endoleaks after endovascular repair of abdominal aortic aneurysms [J]. Radiology, 2000, 215(2): 409413.
44.	Peterson BG, Longo GM, Matsumura JS, et al. Endovascular repair of thoracic aortic pathology with custommade devices [J]. Surgery, 2005, 138(4): 598605.
45.	Golzarian J, Valenti D. Endoleakage after endovascular treatment of abdominal aortic aneurysms: Diagnosis, significance and treatment [J]. Eur Radiol, 2006, 16(12): 28492857.
46.	Peynircioˇｇlu B, Türkbey B, Ozkan M, et al. Use of glue and microcoils for transarterial catheter embolization of a type 1 endoleak [J]. Diagn Interv Radiol, 2008, 14(2): 111115．.
47.	Utíkal P, Kcher M, Bachleda P, et al. Banding in aortic stentgraft fixation in EVAR [J]. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2004, 148(2): 175178．.
48.	van Schie G, Sieunarine K, Holt M, et al. Successful embolization of persistent endoleak from a patent inferior mesenteric artery [J]. J Endovasc Surg, 1997, 4(3): 312315．.
49.	叶开创, 陆信武, 李维敏, 等. 经动脉栓塞治疗腹主动脉瘤患者腔内修复术后持续性Ⅱ型内漏的荟萃分析 [J]. 中华医学会杂志, 2008, 88(25): 17321735.
50.	van Nes JG, Hendriks JM, Tseng LN, et al. Endoscopic aneurysm sac fenestration as a treatment option for growing aneurysms due to type Ⅱ endoleak or endotension [J]. J Endovasc Ther, 2005, 12(4): 430434．.
51.	Nevala T, Biancari F, Manninen H, et al. Type Ⅱ endoleak after endovascular repair of abdominal aortic aneurysm: effectiveness of embolization [J]. J Cardiovasc Intervent Radiol, 2010, 33(2): 278284.
52.	Jonker FH, Aruny J, Muhs BE. Management of type Ⅱ endoleaks: preoperative versus postoperative versus expectant management [J]. Semin Vasc Surg, 2009, 22(3): 165171.
53.	Rose J, Williams R. Management of endoleaks following endovascular aneurysm repair [J]. C2I2, 2006, Ⅳ(3): 1417.
54.	Boyle JR. Longterm outcome of endovascular abdominal aortic aneurysm repair [J]. Br J Surg, 2009, 96(5): 447448．.
55.	Angouras DC, Dosios TJ, Dimitriou CA, et al. Surgical thoracic sympathectomy induces structural and biomechanical remodeling of the thoracic aorta in a porcine model [J]. J Surg Res, 2010 Sep 17 [Epub ahead of print].
56.	中华医学会外科学分会血管外科学组. 腹主动脉瘤诊断与治疗指南 [J]. 中国实用外科杂志, 2008, 28(11): 916918.
57.	Houbballah R, Majewski M, Becquemin JP. Significant sac retraction after endovascular aneurysm repair is a robust indicator of durable treatment success [J]. J Vasc Surg, 2010, 52(4): 878883.
58.	刘志朋, 李颖, 张昱. 基于磁性材料磁力抑制动脉瘤支架内漏的研究 [J]. 中国组织工程研究与临床康复, 2008, 12(19): 36503654.

1. Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms [J]. Ann Vasc Surg, 1991, 5(6): 491499.
2. Lovegrove RE, Javid M, Magee TR, et al. A metaanalysis of 21 178 patients undergoing open or endovascular repair of abdominal aortic aneurysm [J]. Br J Surg, 2008, 95(6): 677684．.
3. Rayt HS, Sutton AJ, London NJ, et al. A systematic review and metaanalysis of endovascular repair (EVAR) for ruptured abdominal aortic aneurysm [J]. Eur J Vasc Endovasc Surg, 2008, 36(5): 536544．.
4. Sajid MS, Desai M, Haider Z, et al. Endovascular aortic aneurysm repair (EVAR) has significantly lower perioperative mortality in comparison to open repair: a systematic review [J]. Asian J Surg, 2008, 31(3): 119123．.
5. Madden N, Baril DT, Wertz R, et al. Endovascular abdominal aortic aneurysm repair: a community hospital’s experience [J]. Vasc Endovascular Surg, 2009, 43(1): 2529.
6. Cao P, De Rango P, Verzini F, et al. Endoleak after endovascular aortic repair: classification, diagnosis and management following endovascular thoracic and abdominal aortic repair [J]. J Cardiovasc Surg (Torino), 2010, 51(1): 5369.
7. White GH, Yu W, May J. Endoleak－a proposed new terminology to describe incomplete aneurysm exclusion by an endoluminal graft [J]. J Endovasc Surg, 1996, 3(1): 124125.
8. Veith FJ, Baum RA, Ohki T, et al. Nature and significance of endoleaks and endotension: summary of opinions expressed at an international conference [J]. J Vasc Surg, 2002, 35(5): 10291035.
9. 景在平, 梅志军. 主动脉夹层腔内隔绝术后内漏的处理 [J]. 中国普外基础与临床杂志, 2006, 13(6): 632．.
10. Buth J, Laheij RJ. Early complications and endoleaks after endovascular abdominal aortic aneurysm repair: report of a multicenter study [J]. J Vasc Surg, 2000, 31(1 Pt 1): 134146．.
11. Buth J, Harris PL, van Marrewijk C, et al. The significance and management of different types of endoleaks [J]. Semin Vasc Surg, 2003, 16(2): 95102.
12. Buth J, Harris PL, Hobo R, et al. Neurologic complications associated with endovascular repair of thoracic aortic pathology: Incidence and risk factors. A study from the European Collaborators on Stent/Graft Techniques for Aortic Aneurysm Repair (EUROSTAR) registry [J]. J Vasc Surg, 2007, 46(6): 11031110．.
13. Franks SC, Sutton AJ, Bown MJ, et al. Systematic review and metaanalysis of 12 years of endovascular abdominal aortic aneurysm repair [J]. Eur J Vasc Endovasc Surg, 2007, 33(2): 154171．.
14. Chuter TA, Parodi JC, LawrenceBrown M. Management of abdominal aortic aneurysm: a decade of progress [J]. J Endovasc Ther, 2004, 11 Suppl 2: Ⅱ82Ⅱ95．.
15. Sampaio SM, Panneton JM, Mozes GI, et al. Proximal type Ⅰ endoleak after endovascular abdominal aortic aneurysm repair: predictive factors [J]. Ann Vasc Surg, 2004, 18(6): 621628.
16. Schurink GW, Aarts NJ, van Baalen JM, et al. Stent attachment siterelated endoleakage after stent graft treatment: An in vitro study of the effects of graft size, stent type, and atherosclerotic wall changes [J]. J Vasc Surg, 1999, 30(4): 658667．.
17. Yamaguchi M, Sugimoto K, Zamora CA, et al. Placement of selfexpanding stents with different diameters in the porcine venous system: an experimental study [J]. J Vasc Interv Radiol, 2006, 17(1): 113119.
18. Walschot LH, Laheij RJ, Verbeek AL. Outcome after endovascular abdominal aortic aneurysm repair: a metaanalysis [J]. J Endovasc Ther, 2002, 9(1): 8289.
19. Greenberg RK, West K, Pfaff K, et al. Beyond the aortic bifurcation: branched endovascular grafts for thoracoabdominal and aortoiliac aneurysms [J]. J Vasc Surg, 2006, 43(5): 879886.
20. Fan CM, Rafferty EA, Geller SC, et al. Endovascular stentgraft in abdominal aortic aneurysms: the relationship between patent vessels that arise from the aneurysmal sac and early endoleak [J]. Radiology, 2001, 218(1): 176182．.
21. Baum RA, Carpenter JP, Cope C, et al. Aneurysm sac pressure measurements after endovascular repair of abdominal aortic aneurysms [J]. J Vasc Surg, 2001, 33(1): 3241．.
22. Fairman RM, Carpenter JP, Baum RA, et al. Potential impact of therapeutic warfarin treatment on type Ⅱ endoleaks and sac shrinkage rates on midterm followup examination [J]. J Vasc Surg, 2002, 35(4): 679685．.
23. Bobadilla JL, Hoch JR, Leverson GE, et al. The effect of warfarin therapy on endoleak development after endovascular aneurysm repair (EVAR) of the abdominal aorta [J]. J Vasc Surg, 2010, 52(2): 267271.
24. Iyer VS, Mackenzie KS, Corriveau MM, et al. Reversible endotension associated with excessive warfarin anticoagulation [J]. J Vasc Surg, 2007, 45(3): 600602.
25. Tanski W 3rd, Fillinger M. Outcomes of original and lowpermeability Gore Excluder endoprosthesis for endovascular abdominal aortic aneurysm repair [J]. J Vasc Surg, 2007, 45(2): 243249.
26. 叶红, 范占明. 腹主动脉瘤破裂的危险因素及影像学研究进展 [J]. 中国介人影像与治疗学, 2009, 6(4): 367370.
27. Iezzi R, Cotroneo AR, Filippone A, et al. Multidetectorrow computed tomography angiography in abdominal aortic aneurysm treated with endovascular repair: evaluation of optimal timing of delayed phase imaging for the detection of lowflow endoleaks [J]. J Comput Assist Tomogr, 2008, 32(4): 609615.
28. Schmieder GC, Stout CL, Stokes GK, et al． Endoleak after endovascular aneurysm repair: duplex ultrasound imaging is better than computed tomography at determining the need for intervention [J]. J Vasc Surg, 2009, 50(5): 10121017.
29. Frydrychowicz A, Harloff A, Jung B, et al. Timeresolved, 3dimensional magnetic resonance flow analysis at 3 T: visualization of normal and pathological aortic vascular hemodynamics [J]. J Comput Assist Tomogr, 2007, 31(1): 915．.
30. Alerci M, Oberson M, Fogliata A, et al. Prospective, intraindividual comparison of MRI versus MDCT for endoleak detection after endovascular repair of abdominal aortic aneurysms [J]. Eur Radiol, 2009, 19(5): 12231231.
31. Ellozy SH, Carroccio A, Lookstein RA, et al. First experience in human beings with a permanently implantable intrasac pressure transducer for monitoring endovascular repair of abdominal aortic aneurysms [J]. J Vasc Surg, 2004, 40(3): 405412.
32. Lorelli DR, JeanClaude JM, Fox CJ, et al. Response of plasma matrix metalloproteinase9 to conventional abdominal aortic aneurysm repair or endovascular exclusion: implications for endoleak [J]. J Vasc Surg, 2002, 35(5): 916922．.
33. Mandziak DM, Stanley BM, Foreman RK, et al. Outcome of endoleak following endoluminal abdominal aortic aneurysm repair [J]. ANZ J Surg, 2004, 74(12): 10391042．.
34. Fransen GA, Vallabhaneni SR Sr, van Marrewijk CJ, et al; EUROSTAR. Rupture of infrarenal aortic aneurysm after endovascular repair: a series from EUROSTAR registry [J]. Eur J Vasc Endovasc Surg, 2003, 26(5): 487493．.
35. Hobo R, Buth J; EUROSTAR collaborators. Secondary interventions following endovascular abdominal aortic aneurysm repair using current endografts. A EUROSTAR report [J]. J Vasc Surg, 2006, 43(5): 896902.
36. Tuerff SN, Rockman CB, Lamparello PJ, et al. Are type Ⅱ (branch vessel) endoleaks really benign? [J]. Ann Vasc Surg, 2002, 16(1): 5054.
37. Jones JE, Atkins MD, Brewster DC, et al. Persistent type 2 endoleak after endovascular repair of abdominal aortic aneurysm is associated with adverse late outcomes [J]. J Vasc Surg, 2007, 46(1): 18．.
38. Xenos ES, Stevens SL, Freeman MB, et al. Distribution of sac pressure in an experimental aneurysm model after endovascular repair: the effect of endoleak types Ⅰ and Ⅱ [J]. J Endovasc Ther, 2003, 10(3): 516523．.
39. Timaran CH, Ohki T, Veith FJ, et al. Influence of type Ⅱ endoleak volume on aneurysm wall pressure and distribution in an experimental model [J]. J Vasc Surg, 2005, 41(4): 657663．.
40. Maldonado TS, Gagne PJ. Controversies in the management of type Ⅱ “branch” endoleaks following endovascular abdominal aortic aneurysm repair [J]. Vasc Endovascular Surg, 2003, 37(1): 112.
41. Chong CK, How TV, GillingSmith GL, et al. Modeling endoleaks and collateral reperfusion following endovascular AAA exclusion [J]. J Endovasc Ther, 2003, 10(3): 424432.
42. Chou MM, Ke YM, Wu HC, et al. Temporary crossclamping of the infrarenal abdominal aorta during cesarean hysterectomy to control operative blood loss in placenta previa increta/percreta [J]. Taiwan J Obstet Gynecol, 2010, 49(1): 7276.
43. Baum RA, Carpenter JP, Tuite CM, et al. Diagnosis and treatment of inferior mesenteric arterial endoleaks after endovascular repair of abdominal aortic aneurysms [J]. Radiology, 2000, 215(2): 409413.
44. Peterson BG, Longo GM, Matsumura JS, et al. Endovascular repair of thoracic aortic pathology with custommade devices [J]. Surgery, 2005, 138(4): 598605.
45. Golzarian J, Valenti D. Endoleakage after endovascular treatment of abdominal aortic aneurysms: Diagnosis, significance and treatment [J]. Eur Radiol, 2006, 16(12): 28492857.
46. Peynircioˇｇlu B, Türkbey B, Ozkan M, et al. Use of glue and microcoils for transarterial catheter embolization of a type 1 endoleak [J]. Diagn Interv Radiol, 2008, 14(2): 111115．.
47. Utíkal P, Kcher M, Bachleda P, et al. Banding in aortic stentgraft fixation in EVAR [J]. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2004, 148(2): 175178．.
48. van Schie G, Sieunarine K, Holt M, et al. Successful embolization of persistent endoleak from a patent inferior mesenteric artery [J]. J Endovasc Surg, 1997, 4(3): 312315．.
49. 叶开创, 陆信武, 李维敏, 等. 经动脉栓塞治疗腹主动脉瘤患者腔内修复术后持续性Ⅱ型内漏的荟萃分析 [J]. 中华医学会杂志, 2008, 88(25): 17321735.
50. van Nes JG, Hendriks JM, Tseng LN, et al. Endoscopic aneurysm sac fenestration as a treatment option for growing aneurysms due to type Ⅱ endoleak or endotension [J]. J Endovasc Ther, 2005, 12(4): 430434．.
51. Nevala T, Biancari F, Manninen H, et al. Type Ⅱ endoleak after endovascular repair of abdominal aortic aneurysm: effectiveness of embolization [J]. J Cardiovasc Intervent Radiol, 2010, 33(2): 278284.
52. Jonker FH, Aruny J, Muhs BE. Management of type Ⅱ endoleaks: preoperative versus postoperative versus expectant management [J]. Semin Vasc Surg, 2009, 22(3): 165171.
53. Rose J, Williams R. Management of endoleaks following endovascular aneurysm repair [J]. C2I2, 2006, Ⅳ(3): 1417.
54. Boyle JR. Longterm outcome of endovascular abdominal aortic aneurysm repair [J]. Br J Surg, 2009, 96(5): 447448．.
55. Angouras DC, Dosios TJ, Dimitriou CA, et al. Surgical thoracic sympathectomy induces structural and biomechanical remodeling of the thoracic aorta in a porcine model [J]. J Surg Res, 2010 Sep 17 [Epub ahead of print].
56. 中华医学会外科学分会血管外科学组. 腹主动脉瘤诊断与治疗指南 [J]. 中国实用外科杂志, 2008, 28(11): 916918.
57. Houbballah R, Majewski M, Becquemin JP. Significant sac retraction after endovascular aneurysm repair is a robust indicator of durable treatment success [J]. J Vasc Surg, 2010, 52(4): 878883.
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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Treatment for Endoleaks after Endovascular Repair of Abdominal Aortic Aneurysm

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