Type II Endoleak After Endovascular Repair of Abdominal Aortic Aneurysm: Effectiveness of Embolization

Journal Article · Thu Apr 15 04:00:00 EDT 2010 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-009-9685-5· OSTI ID:21429029

Nevala, Terhi ^[1]; Biancari, Fausto ^[2]; Manninen, Hannu ^[3]; Aho, Pekka-Sakari ^[4]; Matsi, Pekka ^[3]; Maekinen, Kimmo ^[5]; Roth, Wolf-Dieter ^[6]; Yloenen, Kari ^[2]; Lepaentalo, Mauri ^[4]; Peraelae, Jukka ^[1]

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1. Oulu University Hospital, Department of Radiology (Finland)
2. Oulu University Hospital, Department of Surgery (Finland)
3. Kuopio University Hospital, Department of Radiology (Finland)
4. Helsinki University Hospital, Department of Vascular Surgery (Finland)
5. Kuopio University Hospital, Department of Vascular Surgery (Finland)
6. Helsinki University Hospital, Department of Radiology (Finland)

The purpose of this study was to report our experience in treating type II endoleaks after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms. Two hundred eighteen patients underwent EVAR with a Zenith stent-graft from January 2000 to December 2005. During a follow-up period of 4.5 {+-} 2.3 years, solely type II endoleak was detected in 47 patients (22%), and 14 of them underwent secondary interventions to correct this condition. Ten patients had transarterial embolization, and four patients had translumbar/transabdominal embolization. The embolization materials used were coils, thrombin, gelatin, Onyx (ethylene-vinyl alcohol copolymer), and glue. Disappearance of the endoleak without enlargement of the aneurysm sac after the first secondary intervention was achieved in only five of these patients (5/13). One patient without surveillance imaging was excluded from analyses of clinical success. After additional interventions in four patients and the spontaneous disappearance of type II endoleak in two patients, overall clinical success was achieved in eight patients (8/12). One patient did not have surveillance imaging after the second secondary intervention. Clinical success after the first secondary intervention was achieved in two patients (2/9) in the transarterial embolization group and three patients (3/4) in the translumbar embolization group. The results of secondary interventions for type II endoleak are unsatisfactory. Although the small number of patients included in this study prevents reliable comparisons between groups, the results seem to favor direct translumbar embolization in comparison to transarterial embolization.

• OSTI ID: 21429029
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 2 Vol. 33; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
AORTA
ARTERIES
BLOOD COAGULATION FACTORS
BLOOD VESSELS
BODY
CARDIOVASCULAR SYSTEM
COLLOIDS
COPOLYMERS
DISPERSIONS
EMBOLI
ENZYMES
GELATIN
GRAFTS
HYDROLASES
ORGANIC COMPOUNDS
ORGANIC POLYMERS
ORGANS
PEPTIDE HYDROLASES
POLYMERS
PROTEINS
REPAIR
SERINE PROTEINASES
THROMBIN
TRANSPLANTS