{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:13:33Z","timestamp":1777943613963,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2018,3,22]],"date-time":"2018-03-22T00:00:00Z","timestamp":1521676800000},"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":["Vascular"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Management of type 2 endoleaks after endovascular aneurysm repair has been controversial. Some advocate for conservative management, while others believe that intervention is indicated. This study investigated the natural history of type 2 endoleaks in order to derive direction in management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who had endovascular aneurysm repair at the Veterans Affairs Long Beach were retrospectively identified and computerized tomographic angiography was independently reviewed by a radiologist and a vascular surgeon. Type 2 endoleaks were analyzed for the following outcomes: rupture, duration of endoleak, spontaneous resolution, changes in the size of the aneurysm sac, and reintervention rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 160 patients who had completed required follow-up to date (mean 3 years) after endovascular aneurysm repair, 39 (24.4%) patients were identified as having a type 2 endoleak on computerized tomographic angiography imaging. 6 (15.4%) of these 39 patients required repair due to aneurysm sac growth &gt;1\u00a0cm. 2 (5.13%) were repaired with an open procedure and 4 (10.3%) with an endovascular approach. Of these 6 aneurysm leaks requiring repair, 4 (66.7%) had a simultaneous endoleak (types 1 or 3) in addition to the identified type 2 endoleak. Spontaneous resolution of type 2 endoleaks occurred in 16 (41.0%) patients. 4 patients (10.3%) had delayed type 2 endoleaks that presented 4, 9, 12, and 23 months after their 30 day post op computed tomography was normal. None of the 4 patients with delayed type 2 endoleaks required reintervention and none had aneurysm sac growth greater than 5\u00a0mm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Overall, we found that 85% of patients who had type 2 endoleaks did not require intervention after a mean follow-up time of 3 years. The association of a type 1 or 3 endoleak with a type 2 endoleak was more likely to require correction due to aneurysm expansion &gt;1\u00a0cm, thus type 2 endoleaks associated with another type of endoleak require more aggressive management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1708538118766103","type":"journal-article","created":{"date-parts":[[2018,3,23]],"date-time":"2018-03-23T01:54:09Z","timestamp":1521770049000},"page":"524-530","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["The natural history of type 2 endoleaks after endovascular aneurysm repair justifies conservative management"],"prefix":"10.1177","volume":"26","author":[{"given":"Mark","family":"Ajalat","sequence":"first","affiliation":[{"name":"Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA"},{"name":"Department of Surgery, VA Long Beach Healthcare System, Long Beach, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Russell","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA"},{"name":"Department of Surgery, VA Long Beach Healthcare System, Long Beach, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel E","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California Irvine Medical Center, Orange, CA, USA"},{"name":"Department of Surgery, VA Long Beach Healthcare System, Long Beach, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,3,22]]},"reference":[{"key":"bibr1-1708538118766103","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa042002"},{"key":"bibr2-1708538118766103","doi-asserted-by":"crossref","unstructured":"Chandra V, Trang K, Virgin-Downey W, Tran K, Harris EJ, Dalman RL, Lee JT, Mell MW. Management and outcomes of symptomatic abdominal aortic aneurysms during the past 20 years.\n                      Journal of vascular surgery\n                      2017; 66(6): 1679\u20131685.","DOI":"10.1016\/j.jvs.2017.04.033"},{"key":"bibr3-1708538118766103","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.01.007"},{"key":"bibr4-1708538118766103","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.1018"},{"key":"bibr5-1708538118766103","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.05.018"},{"key":"bibr6-1708538118766103","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.06.149"},{"key":"bibr7-1708538118766103","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.02.073"},{"key":"bibr8-1708538118766103","unstructured":"The US Department of Veterans Affairs [Internet]. 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