Effect of endoleaks on changes in aortoiliac volume after endovascular repair for abdominal aortic aneurysm

PURPOSE: To evaluate changes in aortoiliac volume after endovascular repair (EVAR) for abdominal aortic aneurysm (AAA) in patients with and without endoleaks. MATERIALS AND METHODS: We retrospectively analyzed 137 patients who underwent EVAR for AAA. We manually measured the aortoiliac volume on pre-procedural baseline CT angiograms (CTAs) and post-procedural follow-up CTAs. All post-procedural CTAs were evaluated for the presence of endoleaks. Follow-up examinations were grouped into five time points relative to the date of the EVAR procedure and mean aortoiliac volume changes from the baseline were calculated. RESULTS: In 51 patients (37.2), endoleaks were detected during follow-up. In patients without any endoleaks, mean aortoiliac volume decreased by 21.1 from the pre-interventional baseline examination to the last follow-up examination. In patients with any endoleak during follow-up aortoiliac volume increased by 12.2 and in patients with only transient, post-procedural endoleaks (n = 18), aortoiliac volume decreased by 13.4 over the same time period. CONCLUSION: After EVAR for AAA, aortoiliac volume on CT angiography decreases by approximately 20 over time in the absence of endoleaks and increases in the presence of endoleaks. Transient post-procedural endoleaks, however, do not influence long-term volume regression.