title: Cyanoacrylate embolization of endoleaks after abdominal aortic aneurysm repair.
abstract: BACKGROUND
  Type II endoleaks occur in up to a fifth of endoluminal repairs for abdominal aortic aneurysms and are commonly treated when aortic sac expansion can be demonstrated. Technical failure is common when catheter-guided particulates or coil embolic agents are used. Presented here is a feasibility study using catheter-directed N-butyl-2-cyanoacrylate (Histoacryl, Braun, Tuttlingen, Germany) embolotherapy.
  
  
  METHODS
  A retrospective review of the case notes of patients undergoing embolization procedures for type II endoleaks with expanding sacs was performed from this centre's cohort of endoluminal aortic repair patients under surveillance. Data on patients with type II endoleaks who were treated with either or both cyanoacrylate and coil embolization were extracted. The outcomes were then compared.
  
  
  RESULTS
  In total, five cases were identified, and four of these cases had both coil and glue embolization. Technical success was defined as endoleak closure proven on follow-up computed tomographic imaging. Technical success was achieved in all four patients treated with intra-sac cyanoacrylate. One case treated initially with coil embolization was successful. All patients had a computed tomographic scan at 3 months. One minor complication occurred that resolved without treatment.
  
  
  CONCLUSIONS
  Type II endoleaks after EVAR with expanding sacs require treatment. Percutaneous catheter-directed cyanoacrylate embolization offers an alternative to coil or particulate embolization and, in this series, was found to be more likely to result in endoleak closure.
authors.affiliation: Department of Radiology, Christchurch Hospital, Christchurch, New Zealand. tim.buckenham@cdhb.govt.nz
authors.forename: Timothy
authors.initials: T
authors.lastname: Buckenham
authors.forename: Michael
authors.initials: M
authors.lastname: McKewen
authors.forename: Andrew
authors.initials: A
authors.lastname: Laing
authors.forename: Justin
authors.initials: J
authors.lastname: Roake
authors.forename: David
authors.initials: D
authors.lastname: Lewis
authors.forename: Malcolm K
authors.initials: MK
authors.lastname: Gordon
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D011475:Prosthesis Failure; D012189:Retrospective Studies; D018616:Ultrasonography, Doppler, Duplex
chemical_list: D004659:Enbucrilate