Prevalence of aortic aneurysmal sac expansion using CTA in type II endoleak: comparison between endoleak visualization in CTA phase and in delayed phase

Background To compare the prevalence of aneurysmal sac expansion in type II endoleak (T2E) presenting on CTA phase with T2E presenting on delayed phase. Methods A retrospective study at a single tertiary care center in Bangkok, Thailand. Serial measurement of aneurysmal sac diameters was obtained and the prevalence of aneurysmal sac expansion was compared . Results 130 patients were enrolled from January 2005 to December 2019. The prevalence of aneurysmal sac expansion in T2E patients presenting in the CTA phase and delayed phase in this 2-year observational study were 16% and 0%, respectively ( P = 0.065). Age > 80 years (25.8% vs. 8.8%; P = 0.028) and initial aneurysmal sac diameter (71.3 mm vs. 57.7 mm; P = 0.035) were associated with the aneurysmal sac expansion. Aneurysmal sac expansion occurred in 18.3% of patients with patent IMA and 6% of patients with occluded IMA ( P = 0.053). The number and diameter of lumbar artery feeder, and the presence of intrastent thrombus were not associated with aneurysmal sac expansion. T2E presenting on CTA phase resolved in 9.2% of cases compared with 7.14% of delayed phase cases ( P = 1.0). Conclusions The prevalence of aneurysmal sac expansion in T2E patients presenting on CTA phase was not statistically significantly higher than in patients on delayed phase. Age more than 80 years and initial aneurysmal sac diameter were significantly associated with aneurysmal sac expansion.