{
  "abstract": "Background/Objectives: Aneurysm sac expansion is an adverse marker of durability after endovascular aneurysm repair (EVAR). We assessed factors associated with expansion, its prognostic significance, and the effect of preventive embolisation. Methods: PubMed/MEDLINE, Web of Science, and Scopus were searched through 23 August 2026 (PROSPERO CRD420261386132). Random-effects meta-analyses analysed odds ratios (ORs), hazard ratios (HRs), and risk ratios (RRs) separately; risk of bias and certainty were assessed with RoB 2, ROBINS-I, QUIPS, and GRADE. Results: Thirty-three reports (20 independent quantitative studies) were included. Type II endoleak (OR 5.16, 95% confidence interval [CI] 2.53–10.50; HR 3.08, 95% CI 2.11–4.49) and type I endoleak (OR 11.94, 95% CI 5.30–26.90) were associated with expansion (low certainty). Expansion was associated with higher late mortality in a single independent adjusted cohort (HR 1.31, 95% CI 1.14–1.51; very low certainty). Preventive embolisation was associated with lower risks of persistent type II endoleak (RR 0.58, 95% CI 0.34–0.97; low certainty) and reintervention (RR 0.44, 95% CI 0.24–0.82; very low certainty), but neither association remained statistically conclusive in sensitivity analyses. Conclusions: Endoleaks are consistently associated with sac expansion, which appears to identify patients at increased late risk. Effects of preventive embolisation on surrogate outcomes are not robust; prevention of sac expansion and clinical events is unproven.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, University of Valladolid, 47005 Valladolid, Spain",
    "Department of Vascular Surgery, University Clinical Hospital of Valladolid, 47003 Valladolid, Spain",
    "Department of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "María Lourdes del Río-Solá",
      "orcid": "0000-0001-8239-2498"
    },
    {
      "affs": [
        1
      ],
      "name": "Sergio Asensio-Rodríguez"
    },
    {
      "affs": [
        1
      ],
      "name": "Sandra Pérez-Fernández",
      "orcid": "0000-0003-4150-4742"
    },
    {
      "affs": [
        1
      ],
      "name": "Marina Jiménez-Caja"
    },
    {
      "affs": [
        1
      ],
      "name": "Clara de la Torre Casaseca"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/erc9aw2vv2pb1.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15208009",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705855/?tool=EBI",
  "id": "erc9aw2vv2pb1",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/8009",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Aortic aneurysm repair treatments"
    ]
  ],
  "openalex": "W7222197306",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705855/pdf/?tool=EBI",
  "pmcid": "PMC13705855",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/erc9aw2vv2pb1.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15208009",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/8009"
    },
    {
      "first_seen": "2026-10-30T12:21:47Z",
      "native_id": "PMC:PMC13705855",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13705855"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Aortic aneurysm repair treatments",
      "subfield": "general"
    }
  ],
  "title": "Aneurysm Sac Expansion After EVAR: Associated Factors, Prognostic Impact, and Preventive Strategies—A Systematic Review and Meta-Analysis",
  "title_text": "Aneurysm Sac Expansion After EVAR: Associated Factors, Prognostic Impact, and Preventive Strategies—A Systematic Review and Meta-Analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:47Z",
  "url": "https://research.draconitic.com/paper/erc9aw2vv2pb1",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}