title: Translumbar treatment of type II endoleaks after endovascular repair of abdominal aortic aneurysm.
abstract: The modality of treatment and the appropriate time point to treat type II endoleaks after endovascular repair of abdominal aortic aneurysms (EVAR) remain controversial issues. The purpose of the present study was to assess the efficacy of translumbar embolization of type II endoleaks after endovascular repair of aortic aneurysm repair. Eighty-four consecutive patients after EVAR were analyzed for the onset of type II endoleaks. Of these, five patients had experienced translumbar embolization after ineffective intraartrial approach to exclude the endoleak. A combination of several liquid embolic agents was used as sealant. Post-procedural contrast-enhanced ultrasound (CEUS) was used to document the outcome of the embolization. Translumbar embolization was successful in four patients. Complete sealing of the nidus was seen on CEUS 24 h after the procedure. In one patient with a duplication of the inferior vena cava, the procedure was aborted because an additional type Ib endoleak was found. The procedure was well tolerated by all patients. The translumbar approach to treat growing aneurysm sacs in patients with persistent type II endoleaks is safe and well tolerated. The immediate post-interventional outcome as documented on CEUS is promising. Long-term follow-ups are yet to be performed.
authors.affiliation: Department of Cardiovascular Surgery, Hospital Hietzing, Wolkersbergenstr 1, A-1130 Vienna, Austria. michael.gorlitzer@wienkav.at
authors.forename: Michael
authors.initials: M
authors.lastname: Gorlitzer
authors.forename: Gerard
authors.initials: G
authors.lastname: Mertikian
authors.forename: Hubert
authors.initials: H
authors.lastname: Trnka
authors.forename: Alexander
authors.initials: A
authors.lastname: Froeschl
authors.forename: Johann
authors.initials: J
authors.lastname: Meinhart
authors.forename: Gabriel
authors.initials: G
authors.lastname: Weiss
authors.forename: Martin
authors.initials: M
authors.lastname: Grabenwoeger
authors.forename: Thomas
authors.initials: T
authors.lastname: Rand
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000473:pathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D005240:Feasibility Studies; D006801:Humans; D008161:Lumbosacral Region / Q000098:blood supply*; D011475:Prosthesis Failure; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional