A Novel Technique for the Treatment of Type 2 Endoleak After Endovascular Aortic Repair: Sac Embolization with Balloon Occlusion of the Aorta (SEBOA)

Journal Article · Tue Oct 15 04:00:00 EDT 2019 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-019-02299-2· OSTI ID:22970592

Ogawa, Yukihisa ^[1]; Nishimaki, Hiroshi ^[2]; Fujiwara, Keishi ^[1]; Nathan, Itoga K. ^[3]; Iraha, Tomotaka ^[1]; Chiba, Kiyoshi ^[2]; Kotoku, Akiyuki ^[1]; Maruhashi, Takaaki ^[4]; Mimura, Hidefumi ^[1]; Miyairi, Takeshi ^[2]

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1. St. Marianna University School of Medicine, Department of Radiology (Japan)
2. St. Marianna University School of Medicine, Department of Cardiovascular Surgery (Japan)
3. Stanford University School of Medicine, Division of Vascular Surgery (United States)
4. Kitasato University School of Medicine, Department of Emergency and Critical Care Medicine (Japan)

Purpose: We presented a new method of sac embolization using n-butyl-cyanoacrylate (NBCA) with balloon occlusion of the aorta (SEBOA) that can facilitate decreasing flow rate of the involved branches with the goal of type 2 endoleak resolution after endovascular aortic repair (EVAR). Technique: This technique is demonstrated in six patients who required type 2 endoleak treatment including previous technical failure. A transarterial approach was performed in four patients and transabdominal direct puncture in two. Technical success was defined as complete embolization of both involved branches and sac on postoperative CT. Sacography under balloon occlusion of the aorta demonstrated decreased flow rate of the all involved branches in all patients. SEBOA was performed using 25 or 33% of NBCA diluted with lipiodol. Technical success was obtained in 3 of 6 patients, and one major complication was observed with adhesion of NBCA to the microcatheter resulting in foreign body retention. Conclusion: SEBOA may help solve the difficulty of type 2 endoleak treatment after EVAR as decreased flow rate of the involved branches under balloon occlusion of the aorta was achieved in all patients. However, protocols regarding concentration of NBCA or using other embolic materials are needed to improve the success rate.

• OSTI ID: 22970592
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 10 Vol. 42; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
AORTA
COMPUTERIZED TOMOGRAPHY
CONCENTRATION RATIO
FAILURES
FLOW RATE
LIPIODOL
PATIENTS
SPATIAL RESOLUTION
VASCULAR DISEASES