Intrasac fibrin glue injection after platinum coils placement: the efficacy of a simple intraoperative procedure in preventing type II endoleak after endovascular aneurysm repair.
OBJECTIVE
To verify in our experience if fibrin glue injection into the aneurysm sac, made at the end of endovascular aneurysm repair (EVAR), can reduce type II endoleak rates.


METHODS
Between January 2005 and February 2008, 38 patients underwent EVAR for an unruptured abdominal aortic aneurysm. The first 20 consecutive patients (Group A) had standard EVAR while the last 18 patients (Group B) had EVAR with fibrin glue injection into the sac, regardless of type II endoleak's presence.


RESULTS
There was no statistically significant difference between the two groups concerning the surgical time and the time of X-ray exposure (P=0.30 and 0.54, respectively). Type II endoleak rate was significantly higher in Group A compared to Group B (6 cases, 30% vs. 1 case, 5.5%, respectively, P=0.05). Primary short-term clinical success was 95% and 100%, respectively. At 12 months, selective lumbar embolization was performed in two patients in Group A and in one patient in Group B. Patients in Group A had less computed tomography (CT) studies than patients in Group B (2.0 vs. 1.2, respectively, P=0.024).


CONCLUSIONS
Fibrin glue injection is a safe procedure and seems to reduce type II endoleak rates. Patients who received this procedure had fewer CT examinations, with reduced health-care costs.
Pilon
Fabio
F
Operative Unit of Vascular and Endovascular Surgery, San Bortolo Hospital, Vicenza, Italy.
Tosato
Federico
F
Danieli
Dario
D
Campanile
Francesco
F
Zaramella
Massimiliano
M
Milite
Domenico
D
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000191:economics / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000191:economics; D019917:Blood Vessel Prosthesis Implantation / Q000191:economics / Q000295:instrumentation*; D017046:Cost Savings; D004621:Embolization, Therapeutic / Q000191:economics; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage* / Q000191:economics; D017048:Health Care Costs; D006801:Humans; D015552:Injections, Intralesional; D007430:Intraoperative Care; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D011183:Postoperative Complications / Q000191:economics / Q000517:prevention & control*; D011475:Prosthesis Failure; D012189:Retrospective Studies; D013997:Time Factors; D014014:Tissue Adhesives / Q000008:administration & dosage* / Q000191:economics; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives