Objectives: This study evaluated the incidence and outcomes of secondary procedures for Type I endoleaks following endovascular aneurysm repair (EVAR). Methods: From 2002 to 2013, 2496 patients underwent EVAR for treatment of nonruptured (n 1⁄4 2315; 93%) and ruptured (n 1⁄4 181; 7%) abdominal aortic aneurysms (AAAs). Postoperative follow-up included clinical examination, ultrasound, and computed tomography at 1, 6, and 12 months, and yearly thereafter. Patients with Type I endoleaks were either observed without any intervention, underwent endovascular interventions, or surgical explant. Data was prospectively collected. Results: Of 2496 patients that underwent EVAR, over a mean followup of 57 months, 202 (8%) patients were discovered to have Type I endoleaks from proximal (n 1⁄4 111; 55%), distal (n 1⁄4 69; 34%), or proximal and distal (n 1⁄4 22; 11%) stent graft fixation sites. The mean age was 74 years, and the maximum AAA diameter was 6.0 cm. Indications for treatment included asymptomatic Type I endoleaks (n 1⁄4 171; 85%), symptomatic aneurysms (n 1⁄4 14; 7%), or aneurysm rupture (n 1⁄4 17; 8%). In 49 (24%) patients, Type I endoleaks resolved without any further intervention. Treatments included embolization procedures only in 17 (8%), stent graft extensions only in 103 (51%), embolization and stent graft extensions in 19 (9%), and stent graft explant in 14 (7%). Multiple endovascular procedures were required in 41 (20%) patients. Overall operative mortality for all Type I endoleaks was 1.5%; all deaths occurred in patients that presented with ruptured AAAs (3/17; 18%). Conclusions: Our single center long-term EVAR experience indicates that 8% of patients developType I endoleaks. The vastmajority of Type I endoleaks can be treated by endovascular means with limited mortality, and embolization procedures alone can be effective in select patients. If untreated, 24% of Type I endoleaks resolve spontaneously, while 26% lead to AAA rupture. Prospective Multicenter International Trial of EndoAnchor Fixation and Sealing of Aortic Endografts: Indications for Use and Early Results in the ANCHOR Trial William D. Jordan Jr, Jean Paul de Vries Manish Mehta David Varnagy James Joye. University of Alabama at Birmingham Alabama, Ala; St Antonius Hospital, Nieuwegein, The Netherlands; Albany Medical College, Albany, NY; Florida Hospital, Orlando, FL; El Camino Hospital, California, Calif