Type Ib Endoleak after Endovascular Aortic Repair: Occurrence Rate, Management Strategies, and Outcomes. A Systematic Review and Meta-Analysis.
Nicola Cicala, Antonino Di Leo, Claudio Bianchini Massoni et al.
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In 30 seconds
This systematic review and meta-analysis assessed the occurrence, management, and outcomes of type Ib endoleak after endovascular aortic repair (EVAR). It included 37 studies reporting 474 patients with 516 endoleaks. The estimated occurrence rate was 3.7% (95% CI 2.9-4.5). Across treatments, overall technical success was 96.4% (95% CI 94.4% to 98.5%) and clinical success was 95.5% (95% CI 93% to 98%); early mortality was 3.4% (95% CI 1.5-5.4). Endovascular treatment was the most commonly adopted approach.
Key findings
- Type Ib endoleak occurrence after EVAR was estimated at 3.7% (95% CI 2.9-4.5).
- Overall technical success was 96.4% (95% CI 94.4% to 98.5%), and clinical success was 95.5% (95% CI 93% to 98%).
- Estimated early mortality was 3.4% (95% CI 1.5-5.4); recurrence during follow-up was 3.3% (95% CI 1.3-5.4).
- Distal stent-graft extension in the common iliac artery was the most frequently reported treatment (40.9%; 95% CI 23.6-58.2), with technical success of 96.0%.
Why it matters
Type Ib endoleak is a post-EVAR complication that may require further intervention. This synthesis brings together reported treatment patterns and outcomes, showing high pooled technical and clinical success alongside measurable early mortality and recurrence. These estimates can help frame discussions of management outcomes, while recognising that the evidence is drawn from published studies rather than a direct comparison of treatment strategies.
What to keep in mind
The review included studies reporting at least 5 cases, and the abstract does not describe randomised comparisons between treatment approaches; pooled outcomes therefore do not establish which strategy is superior.