Management of endoleak after endovascular aneurysm repair: cuffs, coils, and conversion

Abstract

Endovascular extension grafts, coil embolization, and conversion to open surgery each may be used to effectively repair endoleak. Selection of the treatment method used is determined by the anatomic characteristics of the endoleak and the patient's ability to tolerate conventional repair. Conversion to open repair was uniformly successful. Deployment of an extension cuff was successful when complete closure of the endoleak was achieved. Embolic coils were effective for retrograde endoleaks and provided stabilization of AAA size in selected patients with attachment site endoleaks in limited follow-up.

Endovascular aortic repair – initial experience in the Serbian bi-centric study

“…The incidence of type II endoleaks has been reported to be approximately 10-25% [17][18][19], and this correlates with our results. Our policy is to treat only endoleak type II that cause increase in aneurysm diameter.…”

Endovascular treatment of endoleaks after endovascular abdominal aortic aneurysm repair: personal experience

“…In our study, we also considered disconnection between the proximal cuff and the main graft body as type III endoleaks; however, such a situation has not been codified and may well be regarded as a type I endoleak. There are two main treatment options for type III endoleaks: if the main graft body has become disconnected from a graft limb, attempts should be made to restore continuity of the graft components by adding an adequately sized cuff; if the disconnection is between the proximal cuff and the main graft body the, options are either to fill the vascular component of the sac with metal coils or to implant an aortouniiliac graft inside the previous endograft, exclude the contralateral branch with an occluder and subsequently fashion a femorofemoral bypass [10].…”

Percutaneous Interventions in Aortic Disease

“…In the early approach to repair type I and III endoleaks, open femoral access was used uniformly. 91 Early reports of percutaneous transabdominal coil embolization of type I endoleak indicated a 50% failure rate. 92 In a follow-up study, these investigators supplemented coil embolization with N-butyl cyanoacrylate embolization and achieved 100% success rate in closing type I endoleaks using a percutaneous approach.…”