Pre-emptive nonselective perigraft aortic sac embolization with coils to prevent type II endoleak after endovascular aneurysm repair

A simplified method of pre-emptive perigraft aortic sac embolization to prevent type II endoleak using the Excluder endograft

“…Percutaneous pre-emptive perigraft aneurysm sac embolization has been previously described 1, 2, 3, 4. The presented technique differs in that the embolization system is built through the ipsilateral sheath rather than the contralateral sheath.…”

“…Techniques that have been described include open femoral and percutaneous access with either a second 5F puncture in the contralateral site or upsizing of the contralateral sheath to accommodate the additional wire and catheter in the sac 1, 2, 3. We previously reported our experience with the percutaneous technique using contralateral access with resheathing for the coiling 4 . As of April 2019, our approach has been modified with the use of the Excluder (W. L. Gore & Associates, Flagstaff, Ariz) endograft to simplify the procedure further and to eliminate unnecessary sheath exchanges.…”

Recent Update of Endovascular Type 2 Endoleak Management

“…Many systematic reviews and multicenter studies have been reported [18,19,27,[35][36][37][38][39][40]. Preoperative anatomical risks are usually reported in terms of the combination of the presence or absence of inferior mesenteric artery (IMA) patency and the number of patent side branches, mainly in the lumbar artery (LA).…”

“…Outside of Japan, sac embolization using coils and fibrin glue instead of branch embolization has been reported [36,57]. However, both reports were from single-center studies of small cohorts, and careful evaluations are necessary.…”

“…However, both reports were from single-center studies of small cohorts, and careful evaluations are necessary. Dosluoglu et al [36] defined the presence of four or more patent LAs, a patent IMA ! 3 mm, and a flow lumen diameter !…”