Prevalence of type 2 endoleak after elective Endovascular Aneurysm Repair with polytetrafluoroethylene- or polyester-based endografts.

OBJECTIVE: Type II endoleak is the most frequent complication after endovascular abdominal aneurysm repair. Polytetrafluoroethylene and polyester are the two most commonly used graft materials in EVAR-devices. Biological properties of the material might influence the appearance and persistence of type II endoleak. Therefore, the aim of this study was to evaluate potential differences in the prevalence of Type II endoleak after EVAR between polytetrafluoroethylene and polyester endografts in patients electively treated for an infrarenal AAA.

METHODS: A single center, retrospective observational study, was conducted between January 2011 and January 2022. Preoperative, procedural, and follow-up data were derived from electronic health records. Imaging included computed tomography and/or duplex ultrasound. The primary endpoint was the prevalence of type II endoleak diagnosed within 1-year after EVAR. Secondary endpoints included the prevalence of Type II endoleak throughout follow-up, early (≤ 30 days) and late (> 30 days) type II endoleak, the rate of type II endoleak disappearance during the follow-up period, the prevalence of type 1 and three endoleak, and type II endoleak related re-interventions.

RESULTS: Follow-up was available for 394 patients, 245 in the polyester and 149 in the polytetrafluoroethylene-group. The prevalence of type II endoleak diagnosed within 1-year after endovascular repair was 11.8% in the polyester-group and 21.5% in the polytetrafluoroethylene-group (p=0.010). There was no significant difference in early (≤ 30 days) and late (> 30 days) type II endoleak between groups (p=0.270 and p=0.311). There was no difference in the freedom from endoleak-type II-reinterventions between groups (p=0.877).

CONCLUSION: The prevalence of type II endoleak after elective EVAR is significantly higher with the use of polytetrafluoroethylene-based endografts compared to polyester-based endografts. This difference is mostly based on type II endoleak diagnosed after 30 days follow-up.