Comparison of Type II Endoleak Embolizations: Embolization of Endoleak Nidus Only versus Embolization of Endoleak Nidus and Branch Vessels

详细信息    查看全文

• 作者：Hyeon Yu ; MD^a ; ^{hyeon_yu@med.unc.edu} ; Hemant Desai ; BS^b ; Ari J. Isaacson ; MD^a ; Robert G. Dixon ; MD^a ; Mark A. Farber ; MD^c ; Charles T. Burke ; MD^a
• 关键词：AAA ; abdominal aortic aneurysm ; EVAR ; endovascular aneurysm repair ; IMA ; inferior mesenteric artery ; NBCA ; n-butyl cyanoacrylate
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：28
• 期：2
• 页码：176-184
• 全文大小：1101 K
• 卷排序：28

文摘

To compare outcomes of type II endoleak embolization involving embolization of the endoleak nidus only vs embolization of the endoleak nidus and branch vessels in patients treated with endovascular repair of abdominal aortic aneurysms.Materials and MethodsTwenty-nine consecutive patients (mean age, 77.9 y; range, 63–88 y) with type II endoleak who underwent embolization from 2004 to 2015 were retrospectively reviewed. Patients were divided into 2 groups: embolization of endoleak nidus only (group A) and embolization of endoleak nidus and branch vessels (group B). Mean follow-up intervals were 20.5 months ± 14.7 in group A and 24.3 months ± 18.5 in group B. Outcomes were compared between groups by Mann–Whitney U and Pearson χ2 tests.ResultsMean interval from endovascular aneurysm repair to embolization was 47.6 months ± 42.9, and mean presentation time of endoleak before embolization was 23.1 months ± 25.8. Coils (n = 28) and liquid embolic agents (n = 23) were used for embolization. There were no significant differences in rates of residual endoleak (50% vs 53.8%; P = .96) or sac decrease/stabilization (62.5% vs 61.5%; P = .64). Procedure time and radiation exposure in group B (132.3 min ± 78.1; 232.4 Gy·cm2 ± 130.7) were greater than in group A (63.4 min ± 11.9; 61.5 Gy·cm2 ± 35.5; P < .01). There were no procedure-related complications.ConclusionsEmbolization of the endoleak nidus and branch vessels is not superior to embolization of only the nidus in terms of occlusion of type II endoleak and change in sac size despite requiring longer procedure times and resulting in greater patient radiation exposure.