Embolization of type II endoleaks after aortic stent-graft implantation: technique and immediate results.
OBJECTIVE
We report the procedural details and immediate results of treatment of type II endoleaks after aortic stent-graft implantation.


METHODS
In a consecutive series of patients who had either Vangard (n = 53) or Talent (n = 7) aortic stent-grafts implanted, type II endoleaks were confirmed by means of angiography in 18 patients, with a mean (+/- SD) age of 69 +/- 11 years; 16 patients had Vangard stent-grafts, and two patients had Talent stent-grafts. After superselective catheterization of the feeding vessel, with 3F microcatheters, and liberal injections of vasodilators, embolization was performed with either a mixture of biologic glue and Lipiodol (n = 16) or Microcoils (n = 2).


RESULTS
The procedure was performed through the femoral artery in 16 patients and through the brachial artery in the remaining two patients. Overall, superselective catheterization and embolization were successfully undertaken in 17 (94.4%) of 18 patients. In the remaining patient, superselective catheterization proved impossible. This patient was treated with an injection of microparticles completed by means of embolization of biologic glue more proximally in an iliolumbar branch. During follow-up (mean, 13.3 months) after embolization, the aneurysm sac shrank in 13 (72.2%) of 18 patients. A new type II endoleak was diagnosed on helical computed tomography or magnetic resonance imaging in two (11.1%) of 18 patients.


CONCLUSIONS
Percutaneous embolization is a safe and effective technique for treatment of type II endoleaks. However, despite these initially promising results, large long-term follow-up studies will be required to confirm its efficiency.
Haulon
S
S
Department of Vascular Surgery, Hôpital Cardiologique, Lille, France.
Tyazi
A
A
Willoteaux
S
S
Koussa
M
M
Lions
C
C
Beregi
J P
JP
D000368:Aged; D000792:Angiography; D015901:Angiography, Digital Subtraction; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D001916:Brachial Artery; D002404:Catheterization / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D003097:Collateral Circulation; D003287:Contrast Media / Q000627:therapeutic use; D004621:Embolization, Therapeutic / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D007459:Iodized Oil / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D017538:Mesenteric Artery, Superior; D019106:Postoperative Hemorrhage / Q000145:classification / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D011475:Prosthesis Failure; D012720:Severity of Illness Index; D015607:Stents / Q000009:adverse effects* / Q000145:classification; D014014:Tissue Adhesives / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
D003287:Contrast Media; D014014:Tissue Adhesives; D014665:Vasodilator Agents; D007459:Iodized Oil