Embolization of type <b>Ⅱ</b> endoleaks after endovascular repair of abdominal aortic aneurysm: a single center experience _CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

TANGHanfei , GUODaqiao , TANGXiao , SHIZhenyu , WANGLixin , LINChangpo , YANDong ,  FUWeiguo

Institute of Vascular Surgery, Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R.China;

Corresponding author：

FUWeiguo, Email: fu.weiguo@zs-hospital.sh.cn

Keywords：

abdominal aortic aneurysm; type Ⅱ endoleak; endovascular repair; embolization

DOI：

10.7507/1007-9424.201612059

Video：

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Objective To evaluate the safety and efficacy of treating type Ⅱ endoleaks after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms with coil embolization. Methods A retrospective review of patients with type Ⅱ endoleaks treated with coil embolization was performed. Data regarding the technical, clinical, and imaging outcomes during perioperation and followed-up were collected. Results The technical success rate and the initial clinical success rate of treating type Ⅱ endoleaks with coil embolization were 100% (14/14). The mean operating time was (124.3±11) min, a mean of (127±15) mL contrast agent and a mean of (7±2) coils were used. During perioperation, one patient suffered left limb paralysis, all the patients were discharged with no perioperative mortality. Twelve patients were followed-up. During the period of 3 to 57 months of followed-up (average: 17.3 months), Type Ⅱ endoleaks reoccurred in one patient with coil embolization of the feeding vessels alone and two patients with coil embolization of the aneurysm sac alone. Since the aneurysms did not enlarge during the followed-up, these 3 patients continued followed-up without reinterventions. Conclusion Treating type Ⅱ endoleaks with coil embolization appears to be safe, and it can prevent aneurysm sac enlargement effectively. Because of the high risk of reoccurrence, follow-up after embolization is important.

Citation： TANGHanfei, GUODaqiao, TANGXiao, SHIZhenyu, WANGLixin, LINChangpo, YANDong, FUWeiguo. Embolization of type Ⅱ endoleaks after endovascular repair of abdominal aortic aneurysm: a single center experience . CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(1): 14-17. doi: 10.7507/1007-9424.201612059 Copy

1.	Giles KA, Pomposelli F, Hamdan A,et al. Decrease in total aneurysm-related deaths in the era of endovascular aneurysm repair. J Vasc Surg, 2009, 49(3): 543-550.
2.	Baum RA, Carpenter JP, Tuite CM,et al. Diagnosis and treatment of inferior mesenteric arterial endoleaks after endovascular repair of abdominal aortic aneurysms. Radiology, 2000, 215(2): 409-413.
3.	Silverberg D, Baril DT, Ellozy SH,et al. An 8-year experience with type Ⅱ endoleaks: natural history suggests selective intervention is a safe approach. J Vasc Surg, 2006, 44(3): 453-459.
4.	Jones JE, Atkins MD, Brewster DC,et al. Persistent type 2 endoleak after endovascular repair of abdominal aortic aneurysm is associated with adverse late outcomes. J Vasc Surg, 2007, 46(1): 1-8.
5.	Dorffner R, Schoder M, Mostbeck G,et al. Inferior mesenteric artery as outflow vessel in endoleaks after abdominal aortic stent-graft implantation: 36-month follow-up CT study. Eur Radiol, 2001, 11(11): 2252-2257.
6.	Tolia AJ, Landis R, Lamparello P,et al. Type Ⅱ endoleaks after endovascular repair of abdominal aortic aneurysms: natural history. Radiology, 2005, 235(2): 683-686.
7.	池振庆, 苗自玲, 吴小鹏. 腔内修复术治疗肾下型腹主动脉瘤的内漏防治: 附43例报告. 中国普通外科杂志, 2013, 22(12): 1548-1552.
8.	Baum RA, Carpenter JP, Golden MA,et al. Treatment of type 2 endoleaks after endovascular repair of abdominal aortic aneurysms: comparison of transarterial and translumbar techniques. J Vasc Surg, 2002, 35(1): 23-29.
9.	Mansueto G, Cenzi D, Scuro A,et al. Treatment of typeⅡ endoleak with a transcatheter transcaval approach: results at 1-year follow-up. J Vasc Surg, 2007, 45(6): 1120-1127.
10.	White S, Stavropoulos S. Management of endoleaks following endovascular aneurysm repair. Semin Intervent Radiol, 2009, 26(1): 33-38.
11.	Martin ML, Dolmatch BL, Fry PD,et al. Treatment of type Ⅱ endoleaks with Onyx. J Vasc Interv Radiol, 2001, 12(5): 629-632.
12.	Golzarian J, Maes EB, Sun S. Endoleak: treatment options. Tech Vasc Interv Radiol, 2005, 8(1): 41-49.
13.	Maldonado TS, Rosen RJ, Rockman CB,et al. Initial successful management of type Ⅰendoleak after endovascular aortic aneurysm repair with n-butyl cyanoacrylate adhesive. J Vasc Surg, 2003, 38(4): 664-670.
14.	Peynircioğlu B, Türkbey B, Ozkan M,et al. Use of glue and microcoils for transarterial catheter embolization of a type 1 endoleak. Diagn Interv Radiol, 2008, 14(2): 111-115.
15.	唐骁, 符伟国, 郭大乔, 等. 腹主动脉瘤腔内修复术后Ⅱ型内漏的栓塞治疗. 中华放射学杂志, 2009, 43(2): 210-211.
16.	Andrew B, Greta KS, Matthew JB,et al. Type Ⅱ endoleaks: challenges and solutions. Vasc Health Risk Manag, 2016, 12: 53-63.
17.	Pandey N, Litt HI. Surveillance Imaging Following Endovascular Aneurysm Repair. Semin Intervent Radiol, 2015, 32(3): 239-248.
18.	Khaja MS, Park AW, Swee W,et al. Treatment of Type Ⅱ Endoleak Using Onyx with long-term imaging follow-up. Cardiovasc Intervent Radiol, 2014, 37(3): 613-622.
19.	Patatas K, Ling L, Dunning J,et al. Static sac size with a type Ⅱ endoleak post-endovascular abdominal aortic aneurysm repair: surveillance or embolization? Interact Cardiovasc Thorac Surg, 2012, 15(3): 462-466.
20.	Chen J, Stavropoulos SW. Management of Endoleaks. Semin Intervent Radiol, 2015, 32(3): 259-264.
21.	Funaki B, Birouti N, Zangan SM,et al. Evaluation and treatment of suspected typeⅡ endoleaks in patients with enlarging abdominal aortic aneurysms. J Vasc Interv Radiol, 2012, 23(7): 866-872.
22.	Nevala T, Biancari F, Manninen H,et al. Type Ⅱ endoleak after endovascular repair of abdominal aortic aneurysm: eﬀectiveness of embolization. Cardiovasc Interv Radiol, 2010, 33(2): 278-284.
23.	Kuziez MS, Sanchez LA, Zayed MA. Abdominal aortic aneurysm typeⅡ endoleaks. J Cardiovasc Dis Diagn. 2016, 4(5): 255.
24.	Kasirajan K, Matteson B, Marek JM,et al. Technique and results of transfemoral superselective coil embolization of type Ⅱ lumbar endoleak. J Vasc Surg, 2003, 38(1): 61-66.
25.	Kajiwara K, Yamagami T, Urashima M,et al. Embolization for type 2 endoleak with sac expansion after endovascular repair of abdominal aortic aneurysm: safety and effectiveness. Springerplus, 2016, 5: 262.
26.	Solis MM, Ayerdi J, Babcock GA,et al. Mechanism of failure in the treatment of type Ⅱ endoleak with percutaneous coil embolization. J Vasc Surg, 2002, 36(3): 485-491.
27.	Güntner O, Zeman F, Wohlgemuth WA,et al. Inferior mesenteric arterial type Ⅱ endoleaks after endovascular repair of abdominal aortic aneurysm: are they predictable? Radiol, 2014, 270(3): 910-919.
28.	Fabre D, Fadel E, Brenot P,et al. Type II endoleak prevention with coil embolization during endovascular aneurysm repair in high-risk patients. J Vasc Surg, 2015, 62(1): 1-7.

1. Giles KA, Pomposelli F, Hamdan A,et al. Decrease in total aneurysm-related deaths in the era of endovascular aneurysm repair. J Vasc Surg, 2009, 49(3): 543-550.
2. Baum RA, Carpenter JP, Tuite CM,et al. Diagnosis and treatment of inferior mesenteric arterial endoleaks after endovascular repair of abdominal aortic aneurysms. Radiology, 2000, 215(2): 409-413.
3. Silverberg D, Baril DT, Ellozy SH,et al. An 8-year experience with type Ⅱ endoleaks: natural history suggests selective intervention is a safe approach. J Vasc Surg, 2006, 44(3): 453-459.
4. Jones JE, Atkins MD, Brewster DC,et al. Persistent type 2 endoleak after endovascular repair of abdominal aortic aneurysm is associated with adverse late outcomes. J Vasc Surg, 2007, 46(1): 1-8.
5. Dorffner R, Schoder M, Mostbeck G,et al. Inferior mesenteric artery as outflow vessel in endoleaks after abdominal aortic stent-graft implantation: 36-month follow-up CT study. Eur Radiol, 2001, 11(11): 2252-2257.
6. Tolia AJ, Landis R, Lamparello P,et al. Type Ⅱ endoleaks after endovascular repair of abdominal aortic aneurysms: natural history. Radiology, 2005, 235(2): 683-686.
7. 池振庆, 苗自玲, 吴小鹏. 腔内修复术治疗肾下型腹主动脉瘤的内漏防治: 附43例报告. 中国普通外科杂志, 2013, 22(12): 1548-1552.
8. Baum RA, Carpenter JP, Golden MA,et al. Treatment of type 2 endoleaks after endovascular repair of abdominal aortic aneurysms: comparison of transarterial and translumbar techniques. J Vasc Surg, 2002, 35(1): 23-29.
9. Mansueto G, Cenzi D, Scuro A,et al. Treatment of typeⅡ endoleak with a transcatheter transcaval approach: results at 1-year follow-up. J Vasc Surg, 2007, 45(6): 1120-1127.
10. White S, Stavropoulos S. Management of endoleaks following endovascular aneurysm repair. Semin Intervent Radiol, 2009, 26(1): 33-38.
11. Martin ML, Dolmatch BL, Fry PD,et al. Treatment of type Ⅱ endoleaks with Onyx. J Vasc Interv Radiol, 2001, 12(5): 629-632.
12. Golzarian J, Maes EB, Sun S. Endoleak: treatment options. Tech Vasc Interv Radiol, 2005, 8(1): 41-49.
13. Maldonado TS, Rosen RJ, Rockman CB,et al. Initial successful management of type Ⅰendoleak after endovascular aortic aneurysm repair with n-butyl cyanoacrylate adhesive. J Vasc Surg, 2003, 38(4): 664-670.
14. Peynircioğlu B, Türkbey B, Ozkan M,et al. Use of glue and microcoils for transarterial catheter embolization of a type 1 endoleak. Diagn Interv Radiol, 2008, 14(2): 111-115.
15. 唐骁, 符伟国, 郭大乔, 等. 腹主动脉瘤腔内修复术后Ⅱ型内漏的栓塞治疗. 中华放射学杂志, 2009, 43(2): 210-211.
16. Andrew B, Greta KS, Matthew JB,et al. Type Ⅱ endoleaks: challenges and solutions. Vasc Health Risk Manag, 2016, 12: 53-63.
17. Pandey N, Litt HI. Surveillance Imaging Following Endovascular Aneurysm Repair. Semin Intervent Radiol, 2015, 32(3): 239-248.
18. Khaja MS, Park AW, Swee W,et al. Treatment of Type Ⅱ Endoleak Using Onyx with long-term imaging follow-up. Cardiovasc Intervent Radiol, 2014, 37(3): 613-622.
19. Patatas K, Ling L, Dunning J,et al. Static sac size with a type Ⅱ endoleak post-endovascular abdominal aortic aneurysm repair: surveillance or embolization? Interact Cardiovasc Thorac Surg, 2012, 15(3): 462-466.
20. Chen J, Stavropoulos SW. Management of Endoleaks. Semin Intervent Radiol, 2015, 32(3): 259-264.
21. Funaki B, Birouti N, Zangan SM,et al. Evaluation and treatment of suspected typeⅡ endoleaks in patients with enlarging abdominal aortic aneurysms. J Vasc Interv Radiol, 2012, 23(7): 866-872.
22. Nevala T, Biancari F, Manninen H,et al. Type Ⅱ endoleak after endovascular repair of abdominal aortic aneurysm: eﬀectiveness of embolization. Cardiovasc Interv Radiol, 2010, 33(2): 278-284.
23. Kuziez MS, Sanchez LA, Zayed MA. Abdominal aortic aneurysm typeⅡ endoleaks. J Cardiovasc Dis Diagn. 2016, 4(5): 255.
24. Kasirajan K, Matteson B, Marek JM,et al. Technique and results of transfemoral superselective coil embolization of type Ⅱ lumbar endoleak. J Vasc Surg, 2003, 38(1): 61-66.
25. Kajiwara K, Yamagami T, Urashima M,et al. Embolization for type 2 endoleak with sac expansion after endovascular repair of abdominal aortic aneurysm: safety and effectiveness. Springerplus, 2016, 5: 262.
26. Solis MM, Ayerdi J, Babcock GA,et al. Mechanism of failure in the treatment of type Ⅱ endoleak with percutaneous coil embolization. J Vasc Surg, 2002, 36(3): 485-491.
27. Güntner O, Zeman F, Wohlgemuth WA,et al. Inferior mesenteric arterial type Ⅱ endoleaks after endovascular repair of abdominal aortic aneurysm: are they predictable? Radiol, 2014, 270(3): 910-919.
28. Fabre D, Fadel E, Brenot P,et al. Type II endoleak prevention with coil embolization during endovascular aneurysm repair in high-risk patients. J Vasc Surg, 2015, 62(1): 1-7.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Embolization of type Ⅱ endoleaks after endovascular repair of abdominal aortic aneurysm: a single center experience

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