Ultrasound-Guided Percutaneous Transabdominal Treatment of a Type 2 Endoleak

Abstract

We describe a case of multiple endoleaks following endovascular repair of an abdominal aortic aneurysm, treated by various methods. A new transabdominal embolization approach using color-flow duplex guidance is presented.

Iatrogenic Ureteral Injury during Translumbar Embolization of a Type II Endoleak

“…The major limitation is that ultrasound often requires a transperitoneal approach, introducing the risk of traversing viscera or mesenteric vessels. 18 In addition, visualization may be limited in obese patients or patients with a large amount of bowel gas. More commonly, the aneurysm sac is approached through the retroperitoneum using fluoroscopy or CT for guidance.…”

Clinical Practice Guidelines for Endovascular Abdominal Aortic Aneurysm Repair: Written by the Standards of Practice Committee for the Society of Interventional Radiology and Endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Interventional Radiology Association

“…Direct sac puncture and embolization via transabdominal approach.-A transabdominal approach with US guidance has been described (216,217). US guidance is used to monitor needle placement on a real-time basis.…”

Ultrasound-Based Guidance and Therapy

“…Successful ultrasound guidance in secondary interventions, for sealing endoleak after endovascular repair, has also been reported. Boks et al [146] described transabdominal embolization using duplex ultrasound guidance, and Kasthuri et al [147] used ultrasound for guiding percutaneous thrombin injection. Navigation of stentgrafts during endovascular procedures has also been demonstrated in patients using CT imaging [148].…”