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J Vasc Interv Radiol. 2019 Apr;30(4):531-538. doi: 10.1016/j.jvir.2018.11.028. Epub 2019 Mar 15.

Effectiveness of Intra-Arterial Aneurysm Sac Embolization for Type Ia Endoleak after Endovascular Aneurysm Repair.

Author information

1
Clinic of Vascular and Endovascular Surgery, University of Münster, Albert-Schweitzer Campus 1, 48145 Muenster, Germany. Electronic address: elena.marchiori@gmail.com.
2
Clinic of Vascular and Endovascular Surgery, University of Münster, Albert-Schweitzer Campus 1, 48145 Muenster, Germany.
3
Department of Vascular and Endovascular Surgery, Saint Franziskus Hospital, Münster, Germany.
4
Clinic of Vascular and Endovascular Surgery, University of Münster, Albert-Schweitzer Campus 1, 48145 Muenster, Germany; Department of Vascular and Endovascular Surgery, Saint Franziskus Hospital, Münster, Germany.

Abstract

PURPOSE:

To evaluate the effectiveness and durability of intra-arterial aneurysm sac embolization for the treatment of type Ia endoleak after endovascular aneurysm repair (EVAR).

MATERIALS AND METHODS:

From February 2011 to December 2016, 22 patients underwent embolization of a type Ia endoleak after EVAR. Four patients (18%) were treated during the index EVAR and 18 (82%) in follow-up. Five patients (23%) were treated urgently and 17 (77%) electively. The embolization was performed with the use of liquid embolic agent, coils, and/or plugs. Adjunctive neck procedures were performed in 55% (n = 12) of the patients. The primary endpoint of this study was freedom from sac enlargement. Key secondary endpoints were technical success and freedom from endoleak-related reinterventions.

RESULTS:

Technical success was 100%. The 30-day mortality was 5% (n = 1; acute coronary syndrome). At a mean follow-up of 15.4 months (range 0.1-65.4) the freedom from sac enlargement rate was 76% (16 out of 21). Reintervention-free survival rates at 6, 12, and 24 months were 80%, 68% and 68%, respectively.

CONCLUSIONS:

In patients with persistent type Ia endoleak the embolization of the aneurysm sac with or without adjunctive neck procedures can be safely performed, leading to acceptable clinical and radiologic outcomes.

PMID:
30879869
DOI:
10.1016/j.jvir.2018.11.028

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