ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Atherosclerosis and Vascular Medicine
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1639697
Development and validation of a nomogram to predict the risk of type II endoleak after endovascular aneurysm repair
Provisionally accepted
- Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, China
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Objective Type II endoleak (T2EL) is the most common complication following endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAA). T2EL may lead to aneurysm sac expansion and rupture. Identifying high-risk patients is crucial for prophylaxis and early intervention.This single-center retrospective study included 332 patients who underwent EVAR for infrarenal AAA. Demographic, clinical, anatomical, and medication-related data were collected. A nomogram was developed based on significant predictors. Its performance was assessed by receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Results T2EL occurred in 70 (21.08%) of 332 patients. Multivariate logistic regression revealed six independent predictors: age, smoking status, intraluminal thrombus (ILT), number of patent lumbar arteries (LA), inferior mesenteric artery (IMA) diameter, and IMA patency. The nomogram demonstrated excellent calibration and strong predictive ability, with an area under the curve (AUC) of 0.806 (training set) and 0.758 (validation set). DCA showed clinical benefit across threshold probabilities of 1-66% and 79-92% in the training set and 1-84% in the validation set. Conclusions The proposed nomogram effectively integrates clinical and anatomical factors to assess the risk of T2EL after EVAR. It may help identify patients requiring intensified surveillance or early interventions to mitigate complications. Further multicenter, prospective studies are needed to validate the nomogram's applicability.
Keywords: Type II endoleak, Endovascular aneurysm repair, nomogram, risk prediction, Aneurysm
Received: 02 Jun 2025; Accepted: 29 Jul 2025.
Copyright: © 2025 Liu, Tang, He and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhong Chen, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, China
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