Aortic side branch embolization before endovascular aneurysm repair: incidence of type II endoleak.
OBJECTIVE
To assess the feasibility of embolization of aortic side branches and its impact on the incidence of type II endoleak after endovascular aneurysm repair.


METHODS
Endovascular aneurysm repair was performed in 74 patients. Aortic side branch vessels were evaluated on the preoperative angiogram and computed tomography (CT) and, where embolization of lumbar and inferior mesenteric vessels was considered technically possible, this was attempted prior to endovascular repair. Follow-up CT was used to assess the presence of type II endoleak.


RESULTS
Seventy-two patients were followed up for longer than 1 month. Embolization was attempted in 25 cases, successfully in 10, with partial success in 11, and failure in four. Twenty patients with successful or partly successful preoperative embolization were discharged and followed-up. Four (20%) had demonstrable type II endoleak during follow-up, with two of these persisting at latest follow-up. Of 43 patients without previous embolization, there were 10 (23.3%) type II endoleaks during the follow-up period, four of these persisting. In cases with type II endoleak, mean sac diameter change was -0.5 mm in the cases with previous embolization and +3.1 mm without. The mean period to onset of type II endoleak was 6.9 months without, and 15.3 months with, previous embolization.


CONCLUSIONS
Although the cohort size is below a level that would confer significance, the trend of these findings is such as to suggest a lack of influence of aortic side branch embolization on the incidence of type II endoleak during the follow-up period.
Gould
D A
DA
Department of Interventional Radiology, Royal Liverpool University Hospital, United Kingdom. derekgould@hotmail.com
McWilliams
R
R
Edwards
R D
RD
Martin
J
J
White
D
D
Joekes
E
E
Rowlands
P C
PC
Brennan
J
J
Gilling-Smith
G
G
Harris
P L
PL
D000792:Angiography; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D021721:Balloon Occlusion; D004621:Embolization, Therapeutic; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011300:Preoperative Care; D013997:Time Factors; D014057:Tomography, X-Ray Computed