{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:55:08Z","timestamp":1791442508284,"version":"4.3.3"},"reference-count":27,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"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":["Vasc Endovascular Surg"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Endovascular abdominal aortic aneurysm repair (EVAR) is the primary treatment for abdominal aortic aneurysm (AAA). Despite favorable early outcomes, lifelong surveillance is essential as endoleaks remain a major cause of reintervention. Among these, type II endoleaks (T2E) remain controversial regarding optimal management. This study aimed to identify factors associated with intervention for T2E using time-to-event analysis and predefined anatomic thresholds. Secondary objectives included comparing outcomes between T2E patients with (intT2E) and without (nointT2E) intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of EVAR procedures from 2011-2024 was performed. Patients with newly diagnosed or persistent T2E were identified on completion and follow-up CT angiography. Patients were categorized as intT2E or nointT2E. Multivariable Cox regression evaluated time to first intervention, and logistic regression served as sensitivity analysis. Kaplan-Meier curves assessed freedom from intervention by inferior mesenteric artery (IMA) size.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 207 EVAR patients, 78 (37.6%) developed T2E over a mean 3.4 \u00b1 2.4 years. Nineteen (24.3%) required intervention. IntT2E patients were younger (74.9 \u00b1 6.8 vs 78.3 \u00b1 7.9 years,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02), had more frequent anticoagulation use (47.4% vs 20.3%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02), larger IMAs (4.2 \u00b1 0.6 vs 3.3 \u00b1 0.7\u00a0mm,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01), and more lumbar arteries (6.0 \u00b1 1.2 vs 5.0 \u00b1 1.3,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02). IMAs &gt;4\u00a0mm occurred in 68.4% of intT2E vs 8.5% of nointT2E (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01). Mean sac growth was greater in intT2E (9.7 \u00b1 5.3\u00a0mm vs \u22121.9 \u00b1 6.5\u00a0mm,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01). Thirty-day complications following the index EVAR procedure, mid-term reinterventions, and overall mortality were similar between groups. Post-embolization, T2E resolved in 36.9%, with sac regression in 63.1%. Among embolized patients, 26.3% required a second embolization and one patient required 3 attempts without achieving resolution. IMA &gt;4 mm independently predicted intervention (HR 7.18, 95% CI 1.97-26.16,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01). Logistic regression confirmed IMA &gt;4\u00a0mm (OR 23.4, 95% CI 6.17-88.6,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01), &gt;6 lumbar arteries (OR 4.2, 95% CI 1.10-15.98,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02), and anticoagulation (OR 3.4, 95% CI 1.17-10.6,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02) as predictors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Approximately one-quarter of T2E patients required embolization. IMA &gt;4 mm was the strongest predictor of intervention, while anticoagulation and increased lumbar artery number also increased risk. Management should prioritize risk-stratified surveillance and selective intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15385744261450590","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T02:47:03Z","timestamp":1778122023000},"page":"664-674","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors for Type 2 Endoleak Requiring Embolization: Large Inferior Mesenteric Artery, Multiple Lumbar Arteries, and Anticoagulation"],"prefix":"10.1177","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4795-3367","authenticated-orcid":false,"given":"Camila","family":"Esquetini Vernon","sequence":"first","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houssam","family":"Farres","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilo","family":"Polania Sandoval","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Ritchie","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beau","family":"Toskich","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Paz Fumagalli","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young","family":"Erben","sequence":"additional","affiliation":[{"name":"Mayo 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