ライフサイエンスコーパス: endoleak

1 formed immediately to identify the suspected endoleak.

2 t accumulation in the aneurysm sac, denoting endoleak.

3 as positive, negative, or indeterminate for endoleak.

4 two radiologists blinded to the diagnosis of endoleak.

5 esence or absence of immediate postoperative endoleak.

6 egardless of the size, pressure, and type of endoleak.

7 P)/ASV% (AUC, 0.69) in indicating persistent endoleak.

8 post-processing to determine the presence of endoleak.

9 and procedure-related complications such as endoleak.

10 re the most sensitive criteria for detecting endoleaks.

11 erage CT data for the presence or absence of endoleaks.

12 -average venous CT data revealed six type II endoleaks.

13 ot be necessary for the routine detection of endoleaks.

14 arterial phase images depicted no additional endoleaks.

15 There were 22 type II and 17 type I or III endoleaks.

16 rred in two patients, each with two separate endoleaks.

17 Duplex US demonstrated six of the seven endoleaks.

18 rysms (EVAR) is mainly aimed at detection of endoleaks.

19 lay an important role in the pathogenesis of endoleaks.

20 w in the IMA is responsible for many type II endoleaks.

21 An expert panel assessed each sequence for endoleaks.

22 vasive method for detecting abdominal aortic endoleaks.

23 was used to assess arterial phase images for endoleaks.

24 ubsequent procedures, most commonly to treat endoleaks.

25 d the reference standard for the presence of endoleaks.

26 e the most common, accounting for 50% of all endoleaks.

27 (LA), complex LA, and complex IMA-LA type II endoleaks.

28 sociated with the development of IMA type II endoleaks.

29 ic (CT) angiography studies revealed type II endoleaks.

30 measurements in the aorta and the detectable endoleaks.

31 S enabled correct classification of 26 of 33 endoleaks.

32 , graft oversizing above 20%, and completion endoleaks.

33 sac size and in patients with type I or III endoleaks.

34 Imaging is critical for detecting endoleaks.

35 CE US depicted 33 endoleaks.

36 Six proximal endoleaks (14.3%) occurred.

37 12 +/- 9), 21 secondary procedures to treat endoleak (20) or to maintain graft limb patency (1) were

38 hes before EVAR than did patients without an endoleak (3.6 +/- 1.7 vs 2.2 +/- 1.4; P < .001).

39 sac rupture 5 (4%), graft migration/ type I endoleak 37 (28%), persistent type II endoleak 40 (38%),

40 type I endoleak 37 (28%), persistent type II endoleak 40 (38%), endotension with sac growth 5 (4%), a

41 systemic inflammatory disease developed more endoleaks (45.1% vs 17.9%; P = .02) and late sac expansi

42 ond +/- 0.83) compared with that for type II endoleaks (9.17 seconds +/- 3.59, P < .0001).

43 e, 60-89 years; mean, 78.5 years) who had an endoleak after endoaortic graft implantation for treatme

44 aging ultrasound (MVUS) for the detection of endoleak after endovascular aortic aneurysm repair.

45 ment, and outcomes of the different types of endoleaks after endovascular abdominal aortic aneurysm r

46 etrospectively evaluated for the presence of endoleaks after endovascular treatment of AAAs in 33 pat

47 g epidemiology, diagnosis, and management of endoleaks after EVAR.

48 iscusses the different treatment options for endoleaks after EVAR.

49 t predictors of AAA sac enlargement included endoleak, age >/= 80 years, aortic neck diameter >/= 28

50 ct identification of 22 (100%) of 22 type II endoleaks, all of which contained a PTC.

51 CT angiography revealed a total of seven endoleaks, all of which were prospectively classified as

52 bles further characterization of the type of endoleak and facilitates appropriate clinical care.

53 The ratios of the ADC value of the endoleak and of the adjacent thrombus to the ADC value w

54 values were significantly different between endoleak and organized or fresh thrombus areas (P < .000

55 Significant endoleak, defined as endoleak and sac diameter increase of 0.5 cm or greater.

56 m sac enlargement are complex IMA-LA type II endoleak and the diameter of the largest feeding and/or

57 NIVE may be able to help characterize endoleak and thrombus organization, regardless of the si

58 guration were compared with the formation of endoleaks and adverse clinical events.

59 The primary outcomes were rates of type III endoleaks and all-cause mortality; and rates of these ou

60 Type IV endoleaks and endotension are uncommon, are typically be

61 Endoleaks and in-stent thrombus of thoracic aorta were d

62 dynamic information differentiates types of endoleaks and shows high diagnostic performance.

63 Detection and conspicuity of endoleaks and subjective image quality were assessed by

64 ment the presence and development of type II endoleaks and the maximal orthogonal aneurysmal sac size

65 rmed every 3-12 months for the evaluation of endoleaks and the maximal sac diameter.

66 aneurysm model containing a stent, simulated endoleaks, and an intraluminal thrombus.

67 ions, perioperative complications and death, endoleaks, and results at 3, 6, and 12 months.

68 ative postoperative scans increases, but new endoleaks are identified as late as 7 years following EA

69 Type II endoleaks are the most common, accounting for 50% of all

70 RECENT FINDINGS: Endoleaks are the most frequent complication after EVAR,

71 Endoleaks are ubiquitous and affect 30% of patients trea

72 verall, CT enabled correct identification of endoleaks as type II or type I or III in 37 (95%) of 39

73 Endoleaks associated with minimal aortic volume increase

74 ntervention [n = 29] and group B, persistent endoleak at follow-up CTA [n = 64]) and compared by usin

75 ynamic CT angiography phases (minimum, seven endoleaks at 2 seconds after the bolus-tracking threshol

76 er the bolus-tracking threshold; maximum, 44 endoleaks at 27 seconds after the bolus-tracking thresho

77 fied a significantly higher risk of type III endoleaks at 5 years among patients receiving any of the

78 for automated detection and localization of endoleaks at aortic digital subtraction angiography (DSA

79 ing method accurately detected and localized endoleaks at DSA imaging from EVAR procedures.

80 The arterial phase images also depicted no endoleaks at these examinations.

81 The Endoleak Augmentor, a custom designed augmentation metho

82 eter was positively associated with risk for endoleak (B = 0.072, P = 0.04).

83 fficient (ADC) mapping can be used to detect endoleaks based on differences in water molecule diffusi

84 after EVAR is required to diagnose and treat endoleaks before they result in aneurysm rupture.

85 ded by significant risks of implantation and endoleak, but the patients' acceptance of the technique

86 Since endoleaks can appear any time after EVAR, at least 1 con

87 Endoleaks can be detected intraoperatively or years late

88 The majority of endoleaks can be treated with endovascular techniques, a

89 The majority of endoleaks can be treated with endovascular techniques.

90 Endovascular repair for AAA is limited by endoleak caused by inflow or outflow malapposition.

91 CT serves as an adequate screening test for endoleak, causing volumetric increase of more than 2% fr

92 e and negative predictive values for type II endoleak cavities with an ECVDEP of less than 0.5 mL for

93 nt of CE US and CT angiographic findings for endoleak classification.

94 e CTA is an accurate predictor of persistent endoleak compared with ENV(AP), and persistent endoleak

95 a significantly increased detection rate of endoleaks compared with the detection rates at the time

96 Endoleaks continue to be a challenge and this article di

97 s: 8 for vascular access complication, 2 for endoleak correction, and 2 for pericardial effusion drai

98 atients underwent secondary interventions: 9 endoleak corrections, 1 open repair for prosthetic kink,

99 cialist using a held-out subset (10 positive endoleak CTAs, 10 control CTAs).

100 Risk for endoleak declines as the number of negative postoperativ

101 Keywords: Endoleaks, Deep Learning, Digital Subtraction Angiograph

102 Significant endoleak, defined as endoleak and sac diameter increase

103 l of 52 patients (24%) who underwent EAR had endoleak detected during postoperative follow-up, which

104 l subtraction angiography all have a role in endoleak detection and management.

105 ew will focus on imaging techniques used for endoleak detection and the role imaging surveillance pla

106 en single-energy and multi-energy images for endoleak detection at CT angiography (CTA) after endovas

107 tic accuracy as compared with 50-keV VMI for endoleak detection at CTA after EVAR.

108 Sensitivity for endoleak detection was higher for SEI (82.6%, 19 of 23;

109 e predictive value, and accuracy of CE US in endoleak detection were 97%, 100%, 100%, 98%, and 99%, r

110 ficity, and diagnostic odds ratio of MVUS in endoleak detection with computed tomography angiography

111 ive values, and accuracy were determined for endoleak detection, and Cohen kappa statistic was used t

112 od sensitivity, specificity, and accuracy in endoleak detection, and it might represent a noninvasive

113 resent study support the use of the MVUS for endoleak detection.

114 dies was negatively associated with risk for endoleak development (B = -3.122, P < 0.001), while incr

115 Endoleak development is a complication of EVAR and repre

116 ssion were used with the end point being new endoleak development.

117 the natural history of and risk factors for endoleak development.

118 L-based approach has similar performance for endoleak diagnosis relative to subspecialists and superi

119 Model accuracy, precision and recall for endoleak diagnosis were 95%, 90% and 100% relative to re

120 s an adjunct to CT angiography in evaluating endoleaks, duplex US provides hemodynamic information th

121 nations performed in 67 patients revealed no endoleak during the venous phase.

122 enlargement and 44 patients (69%) underwent endoleak embolization.

123 chieved when the contrast between aortic and endoleak enhancement reached its maximum.

124 lus-tracking threshold, and the highest mean endoleak enhancement was achieved 22 seconds after the b

125 een patency of sac feeders and rate of early endoleak, especially type 2.

126 Diagnosis of endoleak following endovascular aortic repair (EVAR) rel

127 rysms, carries the risk of recurrence due to endoleaks following stent graft implantation.

128 of patients after EVAR is critical to detect endoleaks for the patient's benefit and to determine the

129 e left subclavian artery), two with type IIo endoleak formation (from other arteries), and three with

130 type Ib endoleak formation, six with type II endoleak formation (from the left subclavian artery), tw

131 f the 64 patients, including 14 with type Ia endoleak formation, one with type Ib endoleak formation,

132 type Ia endoleak formation, one with type Ib endoleak formation, six with type II endoleak formation

133 rom other arteries), and three with type III endoleak formation.

134 One, 6-, 12-, and 24- month endoleak-free survival was 90%, 80%, 77%, and 73%, respe

135 m from aneurysm-related death, type I or III endoleak, graft infection or thrombosis, rupture, or con

136 Patients with an IMA type II endoleak had significantly more patent aortic side branc

137 Ten (62.5%) of the 16 endoleaks have sealed spontaneously during the follow-up

138 in three patients, additional treatment for endoleak in eight patients, and stent-graft collapse or

139 atistically significant predictor of type II endoleak in most patients.

140 cess rate for all indications except type II endoleak in which the initial intervention was successfu

141 Patients without complex IMA-LA type II endoleak in whom the largest feeding and/or draining art

142 m and patients with a complex IMA-LA type II endoleak in whom the largest feeding and/or draining art

143 c, and complete image sets were negative for endoleaks in 100%, 80%, and 100% of patients, respective

144 Sixteen (80%) of the 20 endoleaks in 14 patients were managed with continued obs

145 CT angiography depicted 34 endoleaks in 16 patients (type IA, n=1; type IB, n=1; ty

146 ngiographic (NC-MRA) sequences for detecting endoleaks in participants after endovascular aneurysm re

147 tificial intelligence (AI) tool in detecting endoleaks in patients undergoing endovascular aneurysm r

148 oleak was created in four aneurysms; type II endoleak, in 13 aneurysms; and no endoleak, in one aneur

149 s; type II endoleak, in 13 aneurysms; and no endoleak, in one aneurysm.

150 Two blinded reviewers assessed endoleaks independently in two sessions; the second sess

151 ong-term follow-up (n = 6) to classify their endoleak into a specific type.

152 Endoleak is a common complication of EAR that can lead t

153 doleak compared with ENV(AP), and persistent endoleak is associated with aneurysm sac enlargement, in

154 graphy revealed that the peak enhancement of endoleaks is significantly different than that of the ao

155 Endoleak management depends on the type and presence of

156 should be familiar with the fundamentals of endoleak management to achieve optimal outcomes, includi

157 e used to identify leaks since patients with endoleak may require additional endovascular interventio

158 ly different than that of the aorta and that endoleaks may not be adequately evaluated with conventio

159 r (P < .01) in patients with a type Ia or II endoleak (mean length, 14.3 and 13.9 mm, respectively) t

160 9 mm, respectively) than in patients without endoleaks (mean length, 8.4 mm).

161 The incidence of endoleak, migration, aneurysm enlargement, and graft pat

162 that arterial phase imaging would depict an endoleak missed at venous phase imaging.

163 tion or fabric tear with a subsequent type 3 endoleak (n = 1), and a persistent type 2 endoleak (n =

164 3 endoleak (n = 1), and a persistent type 2 endoleak (n = 13).

165 without occurrence of a clinically relevant endoleak (n = 183).

166 Other late complications included type 1 endoleak (n = 7), aortoduodenal fistula (n = 2), graft t

167 Types I and III high-pressure endoleaks (n = 10) showed a 10.0% (95% CI: 5.0%, 18.2%)

168 Type II low-pressure endoleaks (n = 37) showed a 5.4% (95% CI: 4.6%, 6.2%) in

169 Endoleak occurred in 32.9% of the patients.

170 sac enlargement were complex IMA-LA type II endoleak (odds ratio [OR] = 10.29, P = .004) and the dia

171 as significantly associated with significant endoleak (odds ratio, 5.18; 95% CI, 1.56-17.16; P = .007

172 isceral branches and there was an absence of endoleak on 3-month and 6-month surveillance computed to

173 f a deep neural network for the detection of endoleak on CTA for post-EVAR patients using a novel dat

174 Endoleaks on contrast material-enhanced images were cons

175 Of 17 type I or III endoleaks, only two (12%) contained a PTC and were miscl

176 e group) and 40 patients without evidence of endoleak or aneurysm enlargement (negative group).

177 ir (EAR) requires long-term surveillance for endoleak or increase in aneurysm diameter.

178 m repair could place the patient at risk for endoleak or sac rupture.

179 No endoleaks or aneurysm enlargement was noted either predi

180 Intervention for other endoleaks or endotension is indicated if the aneurysm sa

181 ratio OR, 6.9; P = 0.004) and device-related endoleak (OR, 16.06; P = 0.009).

182 n devices (OR, 1.2; P < 0.01) and late onset endoleak (OR, 64; P < 0.001).

183 ial strains over consecutive heart cycles in endoleak, organized thrombus, and fresh thrombus areas w

184 with the risk of developing a type Ia or IIa endoleak (P < .01).

185 enal dysfunction, renal artery occlusion, or endoleaks (P > .05).

186 not influence the development of IMA type II endoleaks (P = .51).

187 ultidetector CT, Abdominal Aortic Aneurysms, Endoleaks, Perigraft Leak Supplemental material is avail

188 scular treatment of AAAs in 33 patients with endoleak (positive group) and 40 patients without eviden

189 sed from zero to three to four to six, total endoleak rate increased from 6% (one of 17) to 35% (30 o

190 , the total endoleak rate was 17% and type 2 endoleak rate was 13%, as compared with 60% and 50%, res

191 ith zero to three lumbar arteries, the total endoleak rate was 17% and type 2 endoleak rate was 13%,

192 The initial endoleak rate was 22% versus 20%, based on the first CT

193 Relationships of early endoleak rate with total branch vessel, IMA, and lumbar

194 rom 6% (one of 17) to 35% (30 of 86); type 2 endoleak rate, from 0% to 25%.

195 as significantly associated with total early endoleak rate.

196 significantly higher early total and type 2 endoleak rates after stent-graft repair of AAAs; thus, p

197 d with significantly higher total and type 2 endoleak rates: With zero to three lumbar arteries, the

198 y-two patients had a secondary procedure for endoleak repair of which three were conversions to surgi

199 Endoleaks represent blood flow outside the stent-graft l

200 Type I and III endoleaks require intervention.

201 Type I and III endoleaks require urgent intervention to prevent aneurys

202 Up to 90% of type II endoleaks resolve spontaneously or are not associated wi

203 50 CTAs and 20 CTAs with and without endoleak respectively were identified based on gold stan

204 isk for postoperative complications, type II endoleak, sac expansion, and additional interventions af

205 was found between strain values and type of endoleak, sac pressure, endoleak size, and aneurysm size

206 ith the uniphasic/unenhanced set, three (9%) endoleaks (seen only on delayed phase images) were misse

207 At CT, endoleak shape (tubular or nontubular) and location (cen

208 expansion should be monitored carefully and endoleak should be suspected.

209 Type II endoleaks should be observed and treated selectively in

210 Type I endoleaks showed significantly earlier mean peak contras

211 n values and type of endoleak, sac pressure, endoleak size, and aneurysm size.

212 Areas of endoleak, solid organized thrombus, and fresh thrombus w

213 is technology enables wireless monitoring of endoleak status, facilitates timely intervention, and im

214 plications, the most common of which include endoleaks, stenosis or thrombosis at the stagraft and it

215 The 36-month rates of freedom from endoleaks, surgical conversion, and secondary interventi

216 Follow-up outcomes included reinterventions, endoleaks, target vessel patency rates and overall and a

217 Eight of 50 patients (16%) had type II endoleaks that were attributed to retrograde flow in the

218 ined a PTC and were misclassified as type II endoleaks; the remaining 15 (88%) were correctly classif

219 In 56 (49.5%) of 113 CT studies in type II endoleaks, there was an interval increase in ASV.

220 sification) and localization (regression) of endoleaks through multitask learning.

221 The mean ADC ratio of endoleak to aortic stent flow was 0.97 +/- 0.12 (SD), si

222 assess associations between CT findings and endoleak type.

223 ed moderate diagnostic accuracy in detecting endoleaks using LB images but failed to achieve the reli

224 An endoleak was classified as type II if it contained a per

225 Type I endoleak was created in four aneurysms; type II endoleak

226 ke and paraplegia occurred each in 8.0%, and endoleak was diagnosed in 18.4% of patients within the f

227 If an endoleak was identified at 30-day postoperative computed

228 With the biphasic set, one (3%) endoleak was interpreted as indeterminate.

229 t enhancement within the stent lumen and the endoleak was measured.

230 No clinically important endoleak was missed at CE US.

231 ase images were evaluated to determine if an endoleak was present.

232 Endoleak was responsible for 66% of EVAR reinterventions

233 Information on type III endoleaks was available only as free-text mentions in cl

234 Conspicuity of endoleaks was comparable between SEI (median, 2.99) and

235 independent predictors, risk for IMA type II endoleaks was determined with a sensitivity of 78% (39 o

236 The attenuation of the endoleaks was higher during the 80-kVp acquisition (P <

237 sensitivity and specificity for detection of endoleaks was optimal for centerline diameter (64.3% and

238 The incidence of these endoleaks was significantly higher in patients with grea

239 imaging would contribute to the diagnosis of endoleak were determined.

240 8; range, 56-88 years) with EVAR and type II endoleak were included in a single-institution retrospec

241 Twenty-five of the 28 endoleaks were also visualized during the arterial phase

242 diagnostic performance for the detection of endoleaks were calculated for time-resolved CT angiograp

243 and/or draining arteries were measured, and endoleaks were classified according to their sources int

244 stent-grafts were successfully deployed, and endoleaks were clearly depicted in the last follow-up el

245 Seventeen of 19 abdominal endoleaks were confirmed with CE US.

246 Twenty-eight type II endoleaks were detected by using combined nonenhanced an

247 Endoleaks were detected in 26 (40%) of the 64 patients,

248 Endoleaks were detected visually in all scan phases; the

249 Endoleaks were detected with helical computed tomographi

250 With inflow inversion recovery, two type Ia endoleaks were detected, but type Ib and type II endolea

251 In total, 44 endoleaks were detected.

252 Within the positive group, endoleaks were diagnosed with the uniphasic/unenhanced,

253 Four (20%) of the 20 endoleaks were embolized secondary to an increasing aneu

254 Four thoracic and 19 abdominal endoleaks were identified by using time-resolved CT angi

255 Twenty type II endoleaks were identified in 16 (19%) of the 83 patients

256 At 3 months, endoleaks were more common in the older age group (P = 0

257 leaks were detected, but type Ib and type II endoleaks were not detected.

258 Endoleaks were observed in 80 (50%) of 159 patients (59

259 nd treatment in all patients in whom type II endoleaks were observed.

260 the abdominal aorta and of the region of the endoleaks were obtained.

261 In total, 45 endoleaks were present (A: 23 vs B: 22).

262 Endoleaks were present in 82 patients (42%) at discharge

263 Three type II endoleaks were seen only during the venous phase.

264 Endoleaks were visible in 111 of 220 (50.5%) patients.

265 tion should be considered for other types of endoleak when associated with aneurysm sac growth larger

266 isitions contribute to accurate diagnosis of endoleaks when combined with an arterial phase acquisiti

267 s who were observed for this interval had no endoleaks, whereas one patient (patient 3) showed a smal

268 e 2 patients with growth included a type III endoleak (which resolved after treatment) and pressuriza

269 endovascularly with a stent to detect type I endoleaks, which pose the highest rupture risk.

270 acquisition enables detection of additional endoleaks, while an unenhanced acquisition helps elimina

271 ; age range, 52-85 years) with early type II endoleak who had undergone EVAR between December 2002 an

272 Type II endoleaks with a stable or decreased aneurysmal sac size

273 The model identified and localized endoleaks with an area under the receiver operating char

274 hy was performed in patients who had type II endoleaks with an increase in aneurysm sac size and in p

275 The association of IMA type II endoleaks with each variable was analyzed by using univa

276 (P < .001) in type II than in type I or III endoleaks, with a sensitivity, specificity, accuracy, ne

277 o groups (group A, spontaneous resolution of endoleak without intervention [n = 29] and group B, pers

278 Endoleaks without these features were classified as type