{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T11:03:05Z","timestamp":1789556585224,"version":"build-2803163510"},"reference-count":16,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T00:00:00Z","timestamp":1751155200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2026,10]]},"abstract":"\n Objectives:<\/jats:title>\n High-pressure endoleaks (type I and III) after fenestrated-branched endovascular aneurysm repair (F-BEVAR) pose ongoing rupture risk. Early identification of such endoleaks may facilitate appropriate reintervention. Our objective was to determine if persistent thrombocytopenia after F-BEVAR correlates with high-pressure endoleaks in the early postoperative period.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Patients in a physician-sponsored investigational device exemption study of physician-modified and Cook-manufactured fenestrated\/branched endografts were evaluated. Endoleaks identified on computed tomography within the first 6\u2009months of follow-up were classified as high-pressure (type I or III) or low-pressure (type II). Bivariable and multivariable analyses were performed to assess if thrombocytopenia was associated with the presence of endoleaks.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Among 185 patients, 26 (14%) developed high-pressure endoleaks and 30 (16%) developed low-pressure endoleaks. Demographics, procedure indications, and preoperative medications were similar across endoleak groups. To maximize sensitivity and clinical utility, we selected a daily average platelet count <100,000\/\u03bcL as a cut point. The proportion of high-pressure endoleak patients with platelet counts <100,000\/\u03bcL was significantly greater compared to low-pressure and no endoleak patients on postoperative day 1 (POD#1) through POD#4 (high-pressure 42%, low-pressure 27%, no endoleak 10%; p<0.001). After adjusting for demographics and comorbidities, patients with high-pressure endoleak were over 12 times more likely to have average platelets <100,000\/\u03bcL on POD#4 compared to patients with no endoleak (OR 12.3, 95% CI 3.5\u201343.0).<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n F-BEVAR patients who developed high-pressure endoleak had significantly lower platelet counts postoperatively. Aortic imaging should be considered in patients with platelet counts <100,000\/\u03bcL at POD#4 following F-BEVAR, as 35% of such patients will have a high-pressure endoleak requiring reintervention.<\/jats:p>\n <\/jats:sec>\n \n Clinical Impact<\/jats:title>\n Persistent thrombocytopenia following F-BEVAR may be an early indication of a high pressure endoleak. Imaging is recommended for patients with platelet count <100,000\/\u03bcL on POD 4 as 35% of such patients in this study had a high pressure endoleak.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/15266028251351146","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T02:06:48Z","timestamp":1751249208000},"page":"2491-2496","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Persistent Thrombocytopenia Indicates Endoleak After Complex Endovascular Aneurysm Repair"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2246-7926","authenticated-orcid":false,"given":"Annelise","family":"Long","sequence":"first","affiliation":[{"name":"University of Washington School of Medicine, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara L.","family":"Zettervall","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Department of Surgery, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew P.","family":"Sweet","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Department of Surgery, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,29]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004982"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2021.11.074"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.09.041"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2023.05.041"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11604-014-0314-0"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2012.09.034"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.02.029"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.04.010"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.09.062"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.05.036"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/bimj.200410135"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/1708538115596911"},{"key":"e_1_3_2_14_2","article-title":"Systematic review of risk factors and outcomes of post-implantation syndrome following endovascular aortic repair","volume":"79","author":"D\u2019Oria M","year":"2023","unstructured":"D\u2019Oria M, Manoranjithan S, Scoville C, et al. Systematic review of risk factors and outcomes of post-implantation syndrome following endovascular aortic repair. J Vasc Surg. 2023;79:1240\u20131250.e4.","journal-title":"J Vasc Surg"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.3400\/avd.oa.20-00030"},{"key":"e_1_3_2_16_2","article-title":"The Enzen trial: analysis of EVAR endoprosthesis Zenith and Endurant for infrarenal aortoiliac aneurysms regarding outcomes, endoleaks, and reinterventions","volume":"2024","author":"de Athayde Soares R","year":"2024","unstructured":"de Athayde Soares R, Portela MV, Amaro K, et al. The Enzen trial: analysis of EVAR endoprosthesis Zenith and Endurant for infrarenal aortoiliac aneurysms regarding outcomes, endoleaks, and reinterventions. J Endovasc Ther. 2024;2024: 15266028241270895.","journal-title":"J Endovasc Ther"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.07.094"}],"container-title":["Journal of Endovascular Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028251351146","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15266028251351146","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028251351146","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:14:47Z","timestamp":1789553687000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15266028251351146"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,29]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1177\/15266028251351146"],"URL":"https:\/\/doi.org\/10.1177\/15266028251351146","relation":{},"ISSN":["1526-6028","1545-1550"],"issn-type":[{"value":"1526-6028","type":"print"},{"value":"1545-1550","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,29]]}}}