Improving the results of transarterial embolization of type 2 endoleaks with the embolic polymer Onyx.

Wojtaszek, Mikołaj; Wnuk, Emilia; Maciąg, Rafał; Solonynko, Bohdan; Korzeniowski, Krzysztof; Lamparski, Krzysztof; Rowiński, Olgierd

doi:10.5114/wiitm.2016.64747

Cited by 9 publications

(6 citation statements)

References 23 publications

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“…However, the definition of clinical success was not uniform and included the lack of evidence of a residual endoleak and/or the detection of a stable or regressive aneurysm diameter on follow-up CT imaging [24]. Similar clinical success rates for T2EL were also found in later studies with EVOH being used alone or in combination with coils [17,26,27,43]. On a retrospective basis, technically incomplete embolization of T2ELs with EVOH does not necessarily rule out clinical success [26].…”

Section: Technical and Clinical Results Achieved With Evohmentioning

confidence: 97%

Embolization of Type 2 Endoleaks in the Abdominal Aorta Using Ethylene Vinyl Alcohol Copolymer

Nolte-Ernsting¹,

Mecklenbeck²,

Stehr³

2021

Rofo

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Background Type 2 endoleaks (T2EL) are the most frequent complication following endovascular aortic repair. Multiple studies primarily deal with the technical and clinical success of the embolization of persisting T2EL, thereby revealing controversial outcomes. Current reports rarely focus on the detailed execution of such a complex interventional procedure with respect to the difficult anatomic setting. Methods The present review provides an in-depth depiction and evaluation of the interventional methodology of the embolization of T2EL in the abdominal aorta with use of ethylene vinyl alcohol copolymer (EVOH). Complicating anatomic conditions are taken into account as well as technical and clinical success rates. Results Using the transarterial approach, there are at least 4 different pathways to access the nidus of a T2EL. CT-guided direct puncture of the aneurysm sac provides an alternative method of high technical success. EVOH with its slow solidification characteristics enables good control to achieve complete filling of the T2EL. During the intervention, however, it remains difficult to meet exactly the embolization endpoint, especially in large T2ELs. Conclusion T2EL embolization using EVOH is an effective treatment with low major complication rates when conducted by skilled interventionists with detailed knowledge of diverse complex access routes. Key Points: Citation Format

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Section: Technical and Clinical Results Achieved With Evohmentioning

confidence: 97%

Embolization of Type 2 Endoleaks in the Abdominal Aorta Using Ethylene Vinyl Alcohol Copolymer

Nolte-Ernsting¹,

Mecklenbeck²,

Stehr³

2021

Rofo

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“…Previous case series have presented their institutions experience with Onyx ® with favourable results though with no comparison to other embolic agents and variable follow-up times. [21][22][23][24][25] One study found Onyx ® use to have greater success rates than coil or non-Onyx ® glue treatment. 26 A recent systematic review of evidence for Onyx ® as an embolic agent emphasized the lack of data present and with the largest series reporting a median follow-up time of only 4 months.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Clinical Success Following Endovascular Treatment of Type II Endoleaks

2020

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Purpose: To compare long-term outcomes of transarterial (TA) and translumbar (TL) embolization of type II endoleaks (T2E) following EVAR, as well as factors that predict clinical success. Methods: 129 (mean age, 71.4y; range, 53-95) with T2E referred for embolization from August-2003 to December-2017 were retrospectively reviewed. One-hundred-eighty procedures were performed via TA (n = 139) and TL (n = 41) approaches, with 37 patients undergoing 51 reinterventions. Clinical success was defined as absence of endoleak and/or absence of aneurysm sac enlargement on follow-up imaging. Medical comorbidities, procedural data, embolic agents used, presence of successful sac embolization, and 30-day morbidity and mortality data were collected. Results: TL approaches had higher technical success (41/41 vs.122/139, p = .014). Clinical success rates were 52% (N = 58/111) and 62% (N = 23/37) for TA and TL procedures respectively ( p = .34). Looking at all procedures, sac embolization using n-butyl cyanoacrylate glue had higher clinical success compared to other embolic agents ( p = .017-.037). Successful sac access was a strong predictor of success for TA procedures (46/78 vs.12/33, p = .0379). 30-day complication rates were similar between TA (5.8%) and TL (4.9%) approaches. There was 1 death secondary to graft infection following TA embolization. Conclusions: Overall clinical success of TA and TL embolization when considering re-interventions is high. n-butyl cyanoacrylate glue had significantly higher success than other embolic agents ( p = .017-.037). Successful sac access was associated with success for TA procedures.

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“…Die Ergebnisse der Behandlung des Typ-II-Endoleaks mit transarterieller Embolisation zeigen klinische Erfolgsraten (kein weiteres Wachstum des Aneurysmasacks im Follow-up) zwischen 65 und 100 % [ 24 , 33 , 44 , 58 ].…”

Section: Typ-ii-endoleakunclassified

Endovaskuläre Aortenreparatur bei Endoleaks

Hauck

Schernthaner²,

Dachs

et al. 2022

Radiologie

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ZusammenfassungSämtliche Patienten nach endovaskulärer Versorgung eines Aortenaneurysmas bedürfen einer regelmäßigen Nachkontrolle, zumeist in jährlichem Abstand. Der kontrastmittelverstärkte Ultraschall und die Computertomographie-Angiographie (CTA) sind die wichtigsten diagnostischen Modalitäten für die Erkennung von Endoleaks. Die (CTA) erlaubt eine bessere Unterscheidung der verschiedenen Endoleak-Typen. Sogenannte Hochdruck-Endoleaks (Typ I und Typ III) stellen, wenn sich nicht kurzzeitig ein Spontanverschluss zeigt, eine absolute Indikation zur Nachbehandlung dar. Typ-II-Endoleaks weisen in der Mehrzahl einen benignen Verlauf auf. Wenn kein Wachstum des Aneurysmasacks erfolgt, kann eine Nachkontrolle im gewohnten Intervall durchgeführt werden. Typ-II-Endoleaks mit assoziiertem Wachstum des Aneurysmasacks können durch Embolisation der verantwortlichen Gefäße behandelt werden. Ob eine Behandlung immer durchgeführt werden muss, ist umstritten. Eine Behandlungsindikation von einem Typ-II-Endoleak mit wachsendem Aneurysmasack ist jedoch gegeben, wenn durch eine Verkürzung des Aneurysmahalses ein sekundäres Typ-I-Endoleak droht. Typ-I-Endoleaks stellen die Hauptlimitation der Stentgraft-Therapie dar. Die beste Prävention eines Typ-I-Endoleaks ist die Bereitstellung einer adäquaten proximalen Landezone. Dies kann durchaus bedeuten, dass fenestrierte Stentgrafts verwendet werden müssen. Die Verwendung von Schrauben oder anderen Fixationsinstrumenten zur sicheren Behandlung auch kurzer Hälse ist derzeit noch in der Studienphase.

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Improving the results of transarterial embolization of type 2 endoleaks with the embolic polymer Onyx.

Cited by 9 publications

References 23 publications

Embolization of Type 2 Endoleaks in the Abdominal Aorta Using Ethylene Vinyl Alcohol Copolymer

Embolization of Type 2 Endoleaks in the Abdominal Aorta Using Ethylene Vinyl Alcohol Copolymer

Factors Influencing Clinical Success Following Endovascular Treatment of Type II Endoleaks

Endovaskuläre Aortenreparatur bei Endoleaks

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