Background/Objectives: To evaluate the association of preoperative morphometric and morphovolumetric parameters with post-endovascular aneurysm repair (EVAR) sac remodeling, endoleak development, and secondary interventions, and to assess the role of volumetric analysis in post-EVAR surveillance. Methods: This retrospective single-center study included 383 patients who underwent elective EVAR for infrarenal abdominal aortic aneurysm between 2016 and 2024, with available pre- and postoperative computed tomography angiography and at least 1 year of follow-up. Diameter- and volume-based sac dynamics were analyzed using standardized morphometric and 3-dimensional morphovolumetric measurements. Endoleak subtype distribution, risk factors, secondary interventions, and survival were assessed using regression and survival analyses. Results: Endoleaks were detected in 26.1% of patients (n = 100), with type II endoleak being the most frequent subtype (12.3%, n = 47), followed by type Ib (6.8%, n = 26), type III (5.5%, n = 21), type Ia (4.2%, n = 16), and 1 patient with type V endoleak in the revised manuscript framework. Secondary interventions were required in 14.1% of patients (n = 54), mainly for type I and III endoleaks, with a mean time to reintervention of 21.7 ± 10 months. Diameter and volume changes were strongly correlated; a 10% increase in aneurysm volume corresponded to an average 4 mm increase in diameter (R² = 0.72, p < 0.001). Significant predictors of overall endoleak included dual antiplatelet therapy, aneurysm length > 133 mm, elevated pre- and postoperative D-dimer levels, aneurysm diameter > 59 mm, aneurysm volume > 164 cm³, and thrombus volume > 89 cm³. Subtype-specific analyses identified distinct risk profiles for type Ia, Ib, II, and III endoleaks. Overall survival did not differ significantly between patients with and without endoleaks (p = 0.227), although worse survival was observed in type Ia and III endoleaks than in type II and Ib endoleaks. Conclusions: Preoperative morphovolumetric parameters are significant predictors of post-EVAR endoleaks and secondary interventions. Volumetric analysis may provide a complementary early signal of aneurysm sac remodeling beyond conventional diameter-based assessment, particularly in patients with type II endoleaks. However, the proposed volumetric thresholds remain exploratory and require prospective external validation before routine clinical adoption. Post-EVAR management should integrate endoleak subtype, sac behavior, and patient-specific morphovolumetric risk factors to improve surveillance and treatment selection.

Background/Objectives. To compare clinical and angiographic outcomes after staged bilateral ovarian and parauterine vein embolization using coils or vascular plugs in women with pelvic congestion syndrome. Methods. We retrospectively compared 97 coil-treated and 103 plug-treated premenopausal women with complete six-month follow-up after staged bilateral ovarian and parauterine embolization at two centres from February 2025 to March 2026. Device selection reflected anatomy, availability, and operator preference. Left-sided treatment preceded right-sided treatment by approximately one month. Before right-sided embolization, venography assessed filling of previously treated left parauterine veins. Pain was assessed with a continuous-line visual analogue scale (VAS), scored 0–10, at baseline and six months after bilateral completion. Comparisons were unadjusted. Results. Six-month VAS was 1.4 ± 0.7 with coils and 4.2 ± 1.1 with plugs (mean difference, −2.80 points; 95% confidence interval, −3.06 to −2.54; P < .001). Parauterine opacification occurred in 15/97 (15.5%) versus 77/103 (74.8%; risk difference, −59.3 percentage points; 95% confidence interval, −68.7 to −46.8; P < .001). Immediate technical success was reported in all patients. Combined angiographic intervals were 18.0 ± 2.5 versus 22.0 ± 3.7 minutes. Transient increased pelvic pain occurred in 33.0% versus 37.9%. No migration, ovarian vein rupture, or unplanned repeat embolization was reported through six months. Conclusions. Coil treatment was associated with lower six-month pain scores and less parauterine opacification during contralateral venography. Nonrandom device selection and unadjusted comparisons prevent conclusions about causal device superiority.

Objective: To evaluate the association of preoperative morphometric and morphovolumetric parameters with post-endovascular aneurysm repair (EVAR) sac remodeling, endoleak development, and secondary interventions, and to assess the role of volumetric analysis in post-EVAR surveillance. Methods: This retrospective single-center study included 383 patients who underwent elective EVAR for infrarenal abdominal aortic aneurysm between 2016 and 2024, with available pre- and postoperative computed tomography angiography and at least 1 year of follow-up. Diameter- and volume-based sac dynamics were analyzed using standardized morphometric and 3-dimensional morphovolumetric measurements. Endoleak subtype distribution, risk factors, secondary interventions, and survival were assessed using regression and survival analyses. Results: Endoleaks were detected in 26.1% of patients (n = 100), with type II endoleak being the most frequent subtype (12.3%, n = 47), followed by type Ib (6.8%, n = 26), type III (5.5%, n = 21), type Ia (4.2%, n = 16), and 1 patient with type V endoleak in the revised manuscript framework. Secondary interventions were required in 14.1% of patients (n = 54), mainly for type I and III endoleaks, with a mean time to reintervention of 21.7 ± 10 months. Diameter and volume changes were strongly correlated; a 10% increase in aneurysm volume corresponded to an average 4 mm increase in diameter (R² = 0.72, p < 0.001). Volumetric analysis detected sac change earlier than diameter measurements, particularly in stable sacs and type II endoleaks. Significant predictors of overall endoleak included dual antiplatelet therapy, aneurysm length >133 mm, elevated pre- and postoperative D-dimer levels, aneurysm diameter >59 mm, aneurysm volume >164 cm³, and thrombus volume >89 cm³. Subtype-specific analyses identified distinct risk profiles for type Ia, Ib, II, and III endoleaks. Overall survival did not differ significantly between patients with and without endoleaks (p = 0.227), although worse survival was observed in type Ia and III endoleaks than in type II and Ib endoleaks. Conclusion: Preoperative morphovolumetric parameters are significant predictors of post-EVAR endoleaks and secondary interventions. Volumetric analysis appears more sensitive than diameter-based assessment for early detection of sac remodeling, especially in type II endoleaks. Post-EVAR management should integrate endoleak subtype, sac behavior, and patient-specific morphovolumetric risk factors to improve surveillance and treatment selection.