Experience of direct percutaneous sac injection in type II endoleak using cone beam computed tomography

Park, Yoong-Seok; Soo, Young; Park, Hong Suk; Park, Kwang Bo; Kim, Dong Ik

doi:10.4174/astr.2015.88.4.232

Cited by 7 publications

(4 citation statements)

References 5 publications

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“…To overcome this, various techniques have been used for endovascular and percutaneous embolization. Transarterial and direct sac puncture techniques have been used, and recently, alternative approaches including transcaval, transgraft, or perigraft were described [ 18 19 20 21 ]. Recent studies reported higher success and lower complication rates through the direct translumbar approach [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison between Onyx and coil embolization for persistent type 2 endoleaks after endovascular aneurysm repair

Kim,

Park,

Yang

et al. 2024

Ann Surg Treat Res

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Purpose Type 2 endoleaks (T2EL) are the most common form of endoleaks after endovascular aneurysm repair (EVAR). Several studies on the feasibility of embolization using ethylene vinyl alcohol copolymer (Onyx, Medtronic) for T2EL have been reported. The purpose of this study was to compare coil and Onyx embolization for T2EL treatment after EVAR. Methods Between August 2005 and July 2022, 46 patients underwent endovascular embolization for treatment of T2EL (15 Onyx and 31 coils). The primary endpoint was endoleaks resolution or significant aneurysm sac growth of >5 mm in maximal diameter after T2EL embolization. In addition, periprocedural factors, reintervention, sac rupture, and survival analysis were assessed. Results The follow-up period after embolization was significantly shorter in the Onyx group (11.6 months vs. 34.7 months, P = 0.016), and there was no difference in aneurysm sac growth rate between both groups (20.0% vs. 51.6%; P = 0.472, log-rank test). However, cases with multiple endoleak origins tended to be treated with Onyx (P = 0.002). When applying Onyx, there was no significant difference in results between the transarterial and translumbar approaches. Conclusion There appears to be no significant difference in the results of Onyx and coil embolization for T2EL treatment, although it is difficult to evaluate effectiveness due to the small number of cases and short follow-up period. However, in cases of multiple origin endoleaks or when the transarterial approach is not feasible, the Onyx by translumbar approach may be a more effective method.

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Section: Discussionmentioning

confidence: 99%

Comparison between Onyx and coil embolization for persistent type 2 endoleaks after endovascular aneurysm repair

Kim,

Park,

Yang

et al. 2024

Ann Surg Treat Res

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“…Percutaneous sac puncture (PSP) is an interventional procedure consisting in the direct injection of an embolizing agent into the aneurysmatic sac through a percutaneous access [20]. It has been proposed as an alternative option for treatment of T2EL in case of unsuccessful TAE [4,35] or whether endovascular approach is not feasible [20].…”

Section: Percutaneous Sac Puncturementioning

confidence: 99%

“…Several studies presented the value of intraprocedural Cone-Beam CT (CBCT) and Advanced Vessel Detection (AVD) software as problem-solving tool to aid in safe catheterization of offending vessels during TAE of gastrointestinal [15,16] and visceral arterial bleedings [4,17,18] while decreasing total procedure time, contrast dose, and radiation exposure [15,19]; recently the same technology was used to detect the feeders of the ELs [15,16]. When TAE is not feasible (e.g., there are no arterial routes) or unsuccessful, direct percutaneous sac injection (DPSI) and transcaval embolization (TCE) are alternative endovascular methods validated for the treatment of T2EL [5,[20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Operative Management of Type II Endoleaks After Aortic Endovascular Repair

Ierardi

Pesapane

Patella

et al. 2019

Visceral Vessels and Aortic Repair

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“…Coils may also be used to thrombose the sac via the para-graft technique [46]. Finally, successful direct percutaneous sac injection of glue can be performed under cone-beam CT guidance [47].…”

Section: N/a Secondary Endograft or Explantmentioning

confidence: 99%

Endovascular Management of Abdominal Aortic Aneurysms: the Year in Review

O’Mara

Bersin

2016

Curr Treat Options Cardio Med

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Endovascular aneurysm repair (EVAR) has become the predominant method of treatment for abdominal aortic aneurysms (AAA). The use of conscious sedation with local anesthesia and percutaneous femoral access has further decreased the morbidity of the procedure. Current devices can more effectively manage increasingly "hostile" aneurysm necks, while chimney grafts or dedicated fenestrated stent-grafts can be used for juxta-renal disease with favorable results. However, endovascular repair does present a new set of challenges, and endoleaks remain an area of concern. While there is general consensus that type I and type III endoleaks require treatment, type II endoleaks are the topic of ongoing research and debate. Development of devices and techniques to prevent and treat endoleak continues to progress. Advances in contrast-enhanced ultrasound are reducing reliance on computed tomography for post-operative monitoring. This is an important step in this population at high risk for the development of kidney failure. Despite these many innovations, further research is needed to optimize the care of patients with AAA.

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Experience of direct percutaneous sac injection in type II endoleak using cone beam computed tomography

Cited by 7 publications

References 5 publications

Comparison between Onyx and coil embolization for persistent type 2 endoleaks after endovascular aneurysm repair

Comparison between Onyx and coil embolization for persistent type 2 endoleaks after endovascular aneurysm repair

Operative Management of Type II Endoleaks After Aortic Endovascular Repair

Endovascular Management of Abdominal Aortic Aneurysms: the Year in Review

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