Transiliac Paraendograft Embolisation of Type 2 Endoleak: An Alternative Approach for Endoleak Management

Ameli-Renani, Seyed; Pavlidis, Vyzantios; Mailli, Leto; Turner, Paul J.; Morgan, Robert

doi:10.1007/s00270-015-1203-3

Cited by 7 publications

(4 citation statements)

References 9 publications

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“…Using this technique, Coppi and colleagues reported successful embolisation of the sac in 16 of 17 patients [41] using a 9F sheath, with one adverse event of a procedural type Ib endoleak. In the authors experience, paraendograft access with a 4/5Fr catheter alone or a 6Fr sheath is technically adequate and minimises the risk of a procedural type Ib endoleak [42]. In practice, procedural success is limited by difficulty in accessing the paraendograft space and accessing the endoleak nidus even when the sac thrombus has been accessed.…”

Section: Transiliac Paraendograft Embolisation (Tipe)mentioning

confidence: 90%

Secondary Endoleak Management Following TEVAR and EVAR

Ameli-Renani

Pavlidis

Morgan

2020

Cardiovasc Intervent Radiol

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Endovascular abdominal and thoracic aortic aneurysm repair and are widely used to treat increasingly complex aneurysms. Secondary endoleaks, defined as those detected more than 30 days after the procedure and after previous negative imaging, remain a challenge for aortic specialists, conferring a need for long-term surveillance and reintervention. Endoleaks are classified on the basis of their anatomic site and aetiology. Type 1 and type 2 endoleaks (EL1 and EL2) are the most common endoleaks necessitating intervention. The management of these requires an understanding of their mechanics, and the risk of sac enlargement and rupture due to increased sac pressure. Endovascular techniques are the main treatment approach to manage secondary endoleaks. However, surgery should be considered where endovascular treatments fail to arrest aneurysm growth. This chapter reviews the aetiology, significance, management strategy and techniques for different endoleak types.

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Section: Transiliac Paraendograft Embolisation (Tipe)mentioning

confidence: 90%

Secondary Endoleak Management Following TEVAR and EVAR

Ameli-Renani

Pavlidis

Morgan

2020

Cardiovasc Intervent Radiol

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“…After performing an endoleakogram to define the anatomy of the endoleak, any visible and accessible feeding vessels are embolised with a liquid embolic or as in our experience with coils. Using this technique, Coppi and colleagues reported successful embolization of the sac in 16 of 17 patients using a 9F sheath, with one adverse event of a procedural type Ib endoleak [17] , [18] . In practice, procedural success is limited by difficulty in accessing the paraendograft space and accessing the endoleak nidus even when the sac thrombus has been accessed.…”

Section: Discussionmentioning

confidence: 99%

Trans-limb embolization for treatment of Type 2 endoleak post EVAR: Case report

Dinoto

Ferlito

Urso

et al. 2021

International Journal of Surgery Case Reports

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Introduction Type 2 endoleaks (T2EL) occur after 10%–25% of endovascular abdominal aortic aneurysm repairs and increase the risk factor of endograft repair failure and rupture. Herein we report a case of endovascular treatment of T2EL where we performed a trans-limb embolization. Presentation of case A 63-years-old male previously treated for AAA with endovascular aortic aneurysms repair (EVAR), showed an angio-CT scan followup with a type 2 endoleak fed from inferior mesenteric artery (AMI) with growth of AAA greater of 1 cm than preoperative CT-scan and increase of chronic lumbar pain. Due to high risk of rupture was performed a trans-limb embolization with complete sealing. The 6 months CT-angiography showed complete type 2 endoleak exclusion without changes of AAA. Discussion The risk of aneurysm rupture in the presence of an isolated T2EL is exceptionally low. However, when a persistent T2EL is associated with a significant sac size increase, commonly considered as at least 5 mm over 6 months, should be treated. Detachable coils are repositionable, allowing an extremely precise deployment and subsequent embolization of different targets. Conclusion In this experience trans-limb embolization was feasible and this tool should be taken in account especially when no other surgical options exists.

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“…For the sake of completeness, alternative but rarely indicated pathways to the endoleak are mentioned here: Transcaval access [35][36][37], peri-and transgraft access [38,39], and transosseous access [40].…”

Section: Direct Percutaneous Puncturementioning

confidence: 99%

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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Transiliac Paraendograft Embolisation of Type 2 Endoleak: An Alternative Approach for Endoleak Management

Cited by 7 publications

References 9 publications

Secondary Endoleak Management Following TEVAR and EVAR

Secondary Endoleak Management Following TEVAR and EVAR

Trans-limb embolization for treatment of Type 2 endoleak post EVAR: Case report

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

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