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Peer-reviewedCC BYBritish medical bulletin

Clinical predictors of type II endoleaks after EVAR: a systematic review of risk and protective factors.

  1. 1Vascular and Endovascular Surgery Unit, Sant'Andrea Hospital of Rome, Department of Molecular and Clinical Medicine, "Sapienza" University of Rome, Via di Grottarossa, 1035, 00189 Roma RM, Rome, Italy.
  2. 2Vascular and Endovascular Surgery Unit, Sant'Andrea Hospital of Rome, Department of General and Specialistic Surgery, "Sapienza" University of Rome, Piazzale Aldo Moro, 5, 00185 Roma RM, Rome, Italy.

Abstract

Introduction

The present systematic review seeks to examine clinical factors potentially associated with endovascular aortic aneurysm repair (EVAR) failure due to type II endoleaks (TIIEL).Source of data

Relevant literature was sourced from PubMed, including all studies regarding clinical features possibly linked to TIIEL, written in English. Studies focused on anatomical predictors, case reports, and abstracts were excluded. The literature search used keywords related to clinical characteristics, comorbidities, and demographics common in EVAR patients.Areas of agreement

EVAR is the preferred treatment for abdominal aortic aneurysms in eligible patients. The most common complication is endoleak (persistent filling of the sac). TIIEL is caused by retrograde blood flow from aortic side branches and is the most frequent complication, occurring in 16%-50% of cases.Areas of controversy

Many studies have explored anatomical predictors of TIIEL, but limited research is available on clinical factors that may contribute to its occurrence.Growing points

Protective factors against TIIEL included statin therapy, salicylate therapy, smoking, ankle/brachial systolic blood pressure index <0.87, and chronic obstructive pulmonary disease. Conversely, anticoagulation therapy, inflammatory status, and advanced age were associated with an increased risk of TIIEL.Areas timely for developing research

Further prospective research is needed to validate the presented association between clinical factors and EVAR failure due to TIIEL, to allow risk stratification and tailored follow-up strategies for selected groups of patients.

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BibTeX
@article{colonna2026clinical,
  title = {{Clinical predictors of type II endoleaks after EVAR: a systematic review of risk and protective factors.}},
  author = {Giulia Colonna and Chiara Fasulo and Mario Antonelli and Anna Santini and Costanza Morucci and Ginevra Mazzetti and Luigi Rizzo and Maurizio Taurino and Pasqualino Sirignano},
  journal = {British medical bulletin},
  year = {2026},
  month = oct,
  doi = {10.1093/bmb/ldag035},
  url = {https://europepmc.org/article/MED/42896085},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Clinical predictors of type II endoleaks after EVAR: a systematic review of risk and protective factors.
AU  - Giulia Colonna
AU  - Chiara Fasulo
AU  - Mario Antonelli
AU  - Anna Santini
AU  - Costanza Morucci
AU  - Ginevra Mazzetti
AU  - Luigi Rizzo
AU  - Maurizio Taurino
AU  - Pasqualino Sirignano
PY  - 2026
DA  - 2026/10/01
JO  - British medical bulletin
DO  - 10.1093/bmb/ldag035
UR  - https://europepmc.org/article/MED/42896085
AB  - Introduction  The present systematic review seeks to examine clinical factors potentially associated with endovascular aortic aneurysm repair (EVAR) failure due to type II endoleaks (TIIEL).Source of data  Relevant literature was sourced from PubMed, including all studies regarding clinical features possibly linked to TIIEL, written in English. Studies focused on anatomical predictors, case reports, and abstracts were excluded. The literature search used keywords related to clinical characteristics, comorbidities, and demographics common in EVAR patients.Areas of agreement  EVAR is the preferred treatment for abdominal aortic aneurysms in eligible patients. The most common complication is endoleak (persistent filling of the sac). TIIEL is caused by retrograde blood flow from aortic side branches and is the most frequent complication, occurring in 16%-50% of cases.Areas of controversy  Many studies have explored anatomical predictors of TIIEL, but limited research is available on clinical factors that may contribute to its occurrence.Growing points  Protective factors against TIIEL included statin therapy, salicylate therapy, smoking, ankle/brachial systolic blood pressure index <0.87, and chronic obstructive pulmonary disease. Conversely, anticoagulation therapy, inflammatory status, and advanced age were associated with an increased risk of TIIEL.Areas timely for developing research  Further prospective research is needed to validate the presented association between clinical factors and EVAR failure due to TIIEL, to allow risk stratification and tailored follow-up strategies for selected groups of patients.
SN  - 0007-1420
SN  - 1471-8391
ER  -