Type II Endoleak Following Endovascular Repair of Infrarenal Abdominal Aortic Aneurysm: Innovative Transgraft Approach to Contemporary Management

Abstract

Journal of Patient-Centered Research and Reviews ( JPCRR) is a peerreviewed scientific journal whose mission is to communicate clinical and bench research findings, with the goal of improving the quality of human health, the care of the individual patient, and the care of populations. Recommended CitationJan MF, Mewissen MW. Type II endoleak following endovascular repair of infrarenal abdominal aortic aneurysm: innovative transgraft approach to contemporary management. J Patient-Centered Res Rev. 2015;2:118-126.

Transgraft embolization by using long needle for the treatment of type II endoleaks after endovascular abdominal aortic repair

“…Embolization with liquid embolics alone may increase a risk of undesired distal embolization, which could lead to paralysis. 5 , 6 , 7 , 8 , 9 Ironically, embolization with both coils and NBCA may compromise the ability of a contrast-enhanced CT scan to detect potential endoleak owing to halation. Fluoroscopic angiography of the nidus during the TGE could identify type I endoleaks, as well as endoleaks from the vasa vasorum and arteriovenous fistula, which might not be detectable with contrast-enhanced CT scans.…”

“…There are only limited number of case reports regarding transgraft embolization (TGE). 5 , 6 , 7 , 8 In those cases, TGEs were performed with a coronary laser catheter, 6 , 7 Brockenbrough needle (BRK), 8 or transjugular liver access set 6 ; therefore, procedures were not consistent. Since 2013, we applied TGE to evaluate the efficacy of TGE for treatment of T2E when TAE was in technical difficulties (there are no vessels that can be evaluated by computed tomography [CT] images and TAE was unsuccessful).…”

Trans-stent Graft Embolization Using a Brockenbrough Needle for Delayed Rupture Due to Isolated Type II Endoleak after Endovascular Aortic Aneurysm Repair

“…However, the translumbar approach can only be performed in the prone position, which might be unfavorable in a patient with hemorrhagic shock. Other direct sac puncture techniques include transabdominal, transcaval, and trans-stent graft approaches [8]. To the best of our knowledge, there are no reports on the use of trans-stent graft embolization in patients with delayed rupture due to isolated type II endoleak.…”