The aim of this study was to explore the predictive value of endoleak in short-term follow-up after endovascular aortic repair (EVAR) of abdominal aortic aneurysm (AAA) via perioperative laboratory indicators.
A retrospective study included 200 consecutive patients who received standard EVAR treatment for AAA and were followed-up for 1 year. Binary logistic regression analysis was used to evaluate the correlation of the level and changes of perioperative laboratory indicators with the endoleak events during the follow-up. The receiver operating characteristic (ROC) curve was used to assess the predictive value of laboratory indicators for endoleak.
A total of 45 cases of endoleak events occurred during follow-up. Binary logistic regression analysis showed that postoperative fibrinogen decrease, perioperative lymphocyte difference and lymphocyte monocyte ratio (LMR) difference were independent risk factors for short term endoleak. The area under the ROC curve (AUC) of postoperative fibrinogen was 0.596, the cut-off value was 284 mg/dl, and the corresponding specificity and sensitivity were 0.644 and 0.568. The AUC of the lymphocyte difference was 0.622, the cut-off value was −0.45 × 109/L, and the corresponding specificity and sensitivity were 0.651 and 0.568. The AUC of the LMR difference was 0.597, the cut-off value was −1.719, and the corresponding specificity and sensitivity were 0.631 and 0.614.
Decrease of postoperative fibrinogen, increase of lymphocyte difference and LMR difference were independent predictive factors for endoleak in short-term follow-up after EVAR for AAA.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Annals of Vascular Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Progress in endovascular surgical treatment of abdominal aortic aneurysm.Chin J Mod Oper Surg. 2003; 2: 94-96
- National Institute for Health and Care Excellence. Abdominal aortic aneurysm: diagnosis and management, NICE guideline NG156.https://www.nice.org.uk/guidance/NG156Date: 2020Date accessed: March 20, 2020
- Long-term efficacy of EVAR in patients aged less than 65 Years with an infrarenal abdominal aortic aneurysm and favorable anatomy.Ann Vasc Surg. 2020; 67: 283-292
- Endovascular Aortic Aneurysm Repair versus Open Surgical Repair for Abdominal Aortic Aneurysms.A Meta-Analysis[D]Fuzhou:Fujian Medical University, Fuzhou, Fujian Province, China2019
- Complications of endovascular aneurysm repair of the thoracic and abdominal aorta: evaluation and management.Cardiovasc Diagn Ther. 2018; 8: 138-156
- Endoleak as a complication of endoluminal grafting of abdominal aortic aneurysms: classification, incidence, diagnosis, and management.J Endovasc Surg. 1997; 4: 152-168
- Efficacy and anatomical factors of Endurant stent graft in endovascular aortic repair of abdominal aortic aneurysm with hostileneck.Chin J Pract Surg. 2019; 39: 1211-1215
- Endoleak after endovascular aortic repair: classification, diagnosis and management following endovascular thoracic and abdominal aortic repair.J Cardiovasc Surg (Torino). 2010; 51: 53-69
- Funnel technique for EVAR: "a way out" for abdominal aortic aneurysms with ectatic proximal necks.Ann Vasc Surg. 2012; 26: 141-148
- Fenestrated endovascular aneurysm repair versus chimney endovascular aneurysm repair for abdominal aortic aneurysm with complex aneurysm necks:a systemic review and meta-analysis.Chin J Vasc Surg (electronic Version). 2020; 12: 105-111
- Association between perioperative fibrinogen levels and the midterm outcome in patients undergoing elective endovascular repair of abdominal aortic aneurysms.Ann Vasc Surg. 2019; 56: 202-208
- Changes in inflammatory, coagulopathic, and fibrinolytic responses after endovascular repair of an abdominal aortic aneurysm: relationship between fibrinogen degradation product levels and endoleaks.Jpn J Radiol. 2014; 32: 347-355
- The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm.J Vasc Surg. 2018; 67: 2-77
- Preoperative high lymphocyte-to-monocyte ratio is associated with intraoperative type I endoleak in patients with TAA with TEVAR.Vascular. 2022; 30: 977-987
- Prognostic significance of lymphocyte to monocyte ratio in colorectal cancer: a meta-analysis.Int J Surg. 2018; 55: 128-138
- A correlation between monocyte to lymphocyte ratio and long-term prognosis in patients with coronary artery disease after PCI.Clin Appl Thromb Hemost. 2021; 271076029621999717
- Interplay between coagulation and inflammation in open and endovascular abdominal aortic aneurysm repair--impact of intra-aneurysmal thrombus.Scand J Surg. 2007; 96: 229-235
- Association of neutrophil-lymphocyte and platelet-lymphocyte ratio with adverse events in endovascular repair for abdominal aortic aneurysm.J Clin Med. 2021; 10: 1083
- Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio predict in-hospital mortality in symptomatic but unruptured abdominal aortic aneurysm patients.Int Angiol. 2022; 41: 188-195
Published online: January 12, 2023
Accepted: November 24, 2022
Received: September 4, 2022
The first two authors contribute to this work equally.
© 2022 Elsevier Inc. All rights reserved.