Treatment of type 2 endoleaks after endovascular repair of abdominal aortic aneurysms: Comparison of transarterial and translumbar techniques

Baum, Richard A.; Carpenter, Jeffrey P.; Golden, Michael A.; Velázquez, Omaida C.; Clark, Timothy W.I.; Stavropoulous, S. William; Cope, C; Fairman, Ronald M.

doi:10.1067/mva.2002.121068

Cited by 118 publications

(116 citation statements)

References 17 publications

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“…This is thought to be the reason for the lower recurrence rate among translumbar embolizations in Baum's study. 12 In the case presented here, the endoleak recurred despite transarterial embolization of the endoleak and the feeding vessel.…”

Section: Case Reportmentioning

confidence: 98%

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Embolization of a Recurrent Type 2 Endoleak Using the Liquid Embolic n-Butyl Cyanoacrylate

Wilmot

Stavropoulos²

2007

Semin intervent Radiol

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Endovascular aneurysm repair (EVAR) has become an accepted alternative to open aortic aneurysm repair. Endoleaks are one of the most common complications of EVAR and can result in aneurysm enlargement and rupture. When embolization of type 2 endoleaks is needed, a transarterial or translumbar approach may be used. Metal coils are often utilized, but liquid agents have also been used for embolization. This case report involves endoleak embolization using metallic coils along with the liquid embolic agent nbutyl cyanoacrylate (n-BCA).

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Section: Case Reportmentioning

confidence: 98%

“…Baum et al demonstrated a very high endoleak recurrence rate when only the feeding artery was embolized using a transarterial approach. 12 Translumbar embolization allows for embolization of the endoleak itself. This is thought to be the reason for the lower recurrence rate among translumbar embolizations in Baum's study.…”

Section: Case Reportmentioning

confidence: 99%

Embolization of a Recurrent Type 2 Endoleak Using the Liquid Embolic n-Butyl Cyanoacrylate

Wilmot

Stavropoulos²

2007

Semin intervent Radiol

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“…Although conservative management of type 2 endoleaks is recommended in suitable candidates, endovascular treatments are indicated in cases of persistent endoleaks or expansion of the aneurysm [1,4]. However, even with this technique, it is often difficult to completely embolize the endoleak [3][4][5]. Here we report a case of type 2 endoleak with three feeding and two draining arteries that was successfully embolized using the direct translumbar approach.…”

Section: Introductionmentioning

confidence: 98%

Translumbar Embolization of a Type 2 Endoleak after Endovascular Aneurysm Repair Involving Five Communicating Arteries and the Endoleak Sac: A Case Report

Kobayashi

Fujiwara

Hiraki

et al. 2017

Interventional Radiology

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A 46-year-old woman underwent emergent endovascular aneurysm repair for impending rupture of an abdominal aortic aneurysm. Contrast enhanced computed tomography (CT) 10 months after the procedure revealed a type 2 endoleak and enlargement of the aneurysm. Since the transarterial approach to the sac was technically difficult, direct translumbar embolization was performed. An elaster needle was inserted directly into the sac via a translumbar approach. Angiography revealed five arteries communicating with the endoleak sac. The inferior mesenteric artery and bilateral third lumbar arteries were selectively catheterized and embolized with coils. The sac and fourth lumbar arteries were embolized using an n-butyl-2-cyanoacrylatelipiodol mixture. All of the communicating arteries and the sac were successfully embolized without severe complications. Follow-up CT images showed a reduction in the size of the aneurysm.

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“…However, some of these patients when followed up in the long term were found to have late AAA expansion after embolization, leading Sarac et al to conclude that coil embolization alone may not be the best procedure for long term efficacy [20]. Baum et al recommend direct translumbar endoleak embolization preferentially over transarterial endoleak embolization after T2L is confirmed by angiography [21].…”

Section: Journal Of Vascular and Endovascular Surgery Issn 2573-4482mentioning

confidence: 99%

The Natural History of Type 2 Endoleaks after EVAR Justifies Conservative Management

Ajalata¹,

Williamsa²,

Wilsona³

2017

J Vasc Endovasc Surg

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Objective: Management of type 2 endoleaks (T2Ls) after endovascular aneurysm repair (EVAR) has been controversial. Some advocate for conservative management, while others believe that intervention is indicated. This study investigated the natural history of T2Ls in order to derive direction in management. Methods:Patients who had EVAR at the Long Beach VA were retrospectively identified and computerized tomographic angiography (CTA) was independently reviewed by a radiologist and a vascular surgeon. T2Ls were analyzed for the following outcomes: rupture, duration of endoleak, spontaneous resolution, changes in the size of the aneurysm sac, and reintervention rates. Results:Of the 160 patients who had completed required followup to date (mean 3 years) after EVAR, 39 patients (24.4%) were identified as having a T2L on CTA imaging. 6 of these 39 patients (15.4%) required repair due to aneurysm sac growth >1 cm. Two (5.13%) were repaired with an open procedure and 4 (10.3%) with an endovascular approach. Of these 6 aneurysm leaks requiring repair, 4 (66.7%) had a simultaneous endoleak (types 1 or 3) in addition to the identified T2L. Spontaneous resolution of T2Ls occurred in 16 (41.0%) patients. Conclusions:Overall, we found that 85% of patients who had T2Ls did not require intervention after a mean follow up time of 3 years. The association of a type 1 or 3 endoleak with a T2L was more likely to require correction due to aneurysm expansion >1 cm, thus T2Ls associated with another type of endoleak require more aggressive management.

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Treatment of type 2 endoleaks after endovascular repair of abdominal aortic aneurysms: Comparison of transarterial and translumbar techniques

Cited by 118 publications

References 17 publications

Embolization of a Recurrent Type 2 Endoleak Using the Liquid Embolic n-Butyl Cyanoacrylate

Embolization of a Recurrent Type 2 Endoleak Using the Liquid Embolic n-Butyl Cyanoacrylate

Translumbar Embolization of a Type 2 Endoleak after Endovascular Aneurysm Repair Involving Five Communicating Arteries and the Endoleak Sac: A Case Report

The Natural History of Type 2 Endoleaks after EVAR Justifies Conservative Management

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