Transcaval embolization as the preferred approach

Burley, Caroline G.; Kumar, Mark H.; Bhatti, Waseem; Boyd, C. I.; Sales, Clifford M.

doi:10.1016/j.jvs.2018.08.177

Cited by 16 publications

(12 citation statements)

References 7 publications

(10 reference statements)

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“…26 Lastly, a transvenous approach to transcaval embolization has been described. 27,28 With this approach, a curved puncture needle system is used for sac access from the inferior vena cava. This approach provides improved patient comfort with supine positioning but can predispose to hemorrhage, arteriovenous fistulae, or nontarget embolization material entering the vena cava.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Type II Endoleak Treatment Using Ethylene Vinyl Alcohol Copolymer (Onyx^TM)

Nuckles

Nadal

Berger

et al. 2020

Vasc Endovascular Surg

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Introduction: This study reports our experience with the use of an ethylene vinyl alcohol copolymer (Onyx™) for the treatment of type II endoleak after endovascular repair of abdominal aortic aneurysms (EVAR) in comparison to coils and cyanoacrylate glue. Methods: Clinical data of all patients treated for type II endoleak following EVAR between 2009 and 2017 were retrospectively analyzed. Abdominal aortic aneurysm (AAA) diameter and AAA sac volume during follow-up were measured using computed tomography angiography (CTA). Treatment failure variables were created for the change in sac diameter and volume. An increase in sac diameter ≥ 5 mm was considered a failure, as was an increase ≥ 10% in AAA sac volume. Results: 35 patients underwent treatment for a persistent type II endoleak following EVAR. Of these patients, 18 (51.4%) were treated with Onyx and 17 (48.6%) were treated with coils ± cyanoacrylate glue embolization. There were no significant differences between the 2 groups with regard to demographics. The average volume of Onyx used per treatment was 13.4 ml (range 4.5 ml- 39 ml). There was no difference in efficacy between the Onyx and non-Onyx group. Complications were limited to 1 non-target embolization without significant clinical sequelae. Conclusions: Ethylene vinyl alcohol copolymer (Onyx™) embolization is similarly effective compared to traditional cyanoacrylate glue or coil embolization in the treatment of type II endoleak after EVAR.

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Section: Discussionmentioning

confidence: 99%

Outcomes of Type II Endoleak Treatment Using Ethylene Vinyl Alcohol Copolymer (Onyx^TM)

Nuckles

Nadal

Berger

et al. 2020

Vasc Endovascular Surg

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“…In a series of 10 patients, Burley et al performed transcaval access with Rosch-Uchida sets, and embolized using coils, and, if needed, gelatin granules and thrombin slurry. 19 Nine of 10 (90%) patients had decreased aneurysm sac diameters on follow-up imaging at 6 months. Hyatt et al described the use of intravascular ultrasound (IVUS)-guided approach for Rosch-Uchida needle endoleak access from femoral approach.…”

Section: Transvenous Transcavalmentioning

confidence: 94%

“…The most established approaches can be broadly classified into transarterial and direct sac puncture techniques. [17][18][19] Newer, alternative approaches including transgraft 20 and perigraft 21 endoleak catheterizations have also been described. Determination of optimal approach is based on analysis of endoleak and feeder branch anatomy as well as available imaging equipment and provider experience.…”

Section: Embolization Strategiesmentioning

confidence: 99%

“…17 It is not necessary to reflux nBCA into the feeder branches, which can increase the risk of nontarget embolization. Alternative embolization agents to nBCA include thrombin 19 and Onyx, 18,28 all of which have varied administration characteristics. Relative to nBCA, Onyx allows increased control of the Onyx cast, but technical and cost considerations limit its broader use.…”

Section: Embolization Techniquementioning

confidence: 99%

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Type 2 Endoleak Management

Chen¹,

Stavropoulos

2020

Semin intervent Radiol

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Type 2 endoleaks are the most common endoleak type following endovascular aneurysm repair. The natural history of these endoleaks can vary, with some demonstrating a self-limited or indolent course, while others can contribute to aneurysm sac enlargement and rupture. A variety of embolization techniques, including transarterial catheterization and direct sac puncture techniques, have been developed for the treatment of type 2 endoleaks. In this article, the authors review the indications, techniques, and outcomes of current treatment strategies for type 2 endoleaks.

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“…9 Giles et al 47 had an 83% transcaval technical success in 29 patients for treating TIIEL. Burley et al 48 and Scali et al 49 reported 100% success rate on small series (n ¼ 10, n ¼ 6) of patients with TIIEL treated by a transcaval approach; nevertheless, the studies had a short follow-up of 6 months and 8.1 months (range, 2-22 months), respectively. Postoperative complications following this technique include inadvertent intracaval embolization of coils, retroperitoneal hemorrhage, unintentional puncture of the existing endograft leading to type III endoleak, injury to periaortic/ caval structures, and aortocaval fistula.…”

Section: Treatmentmentioning

confidence: 99%

Type II Endoleaks After EVAR: A Literature Review of Current Concepts

González-Urquijo

Lozano-Balderas

2020

Vasc Endovascular Surg

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Endoleak is the most frequent complication following endovascular aneurysm repair, which is not present in the surgical counterpart. The most frequent type of endoleak corresponds to type II, and its natural history remains poorly understood. Therefore, their treatment continues to be a topic of debate. The vast majority of the studies found in the literature are of a retrospective nature, and there are no prospective studies comparing intervention versus a conservative approach. Future studies should aim to compare not only different approaches to resolve type II endoleak but also when should be the right time to treat them, with the primary purpose of avoiding sac rupture. The objective of this review is to provide the reader with a literature overview about type II endoleaks to help in the decision-making process on this topic.

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Transcaval embolization as the preferred approach

Cited by 16 publications

References 7 publications

Outcomes of Type II Endoleak Treatment Using Ethylene Vinyl Alcohol Copolymer (Onyx^TM)

Outcomes of Type II Endoleak Treatment Using Ethylene Vinyl Alcohol Copolymer (Onyx^TM)

Type 2 Endoleak Management

Type II Endoleaks After EVAR: A Literature Review of Current Concepts

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Transcaval embolization as the preferred approach

Cited by 16 publications

References 7 publications

Outcomes of Type II Endoleak Treatment Using Ethylene Vinyl Alcohol Copolymer (OnyxTM)

Outcomes of Type II Endoleak Treatment Using Ethylene Vinyl Alcohol Copolymer (OnyxTM)

Type 2 Endoleak Management

Type II Endoleaks After EVAR: A Literature Review of Current Concepts

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Product

Resources

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Outcomes of Type II Endoleak Treatment Using Ethylene Vinyl Alcohol Copolymer (Onyx^TM)

Outcomes of Type II Endoleak Treatment Using Ethylene Vinyl Alcohol Copolymer (Onyx^TM)