Type II endoleak embolization after endovascular abdominal aortic aneurysm repair with use of real-time three-dimensional fluoroscopic needle guidance.
Current treatment for type II endoleak includes transarterial embolization and translumbar puncture, but each method has its drawbacks. With real-time three-dimensional fluoroscopy guidance, a cone-beam computed tomography (CT) image is created in which the needle trajectory is determined. The trajectory is superimposed on the fluoroscopy image, allowing real-time needle placement for precise embolization. We have used this method to treat five patients with complex type II endoleaks. All interventions were successful and uncomplicated. At 6-month follow-up, CT scan showed no recurrences. Direct puncture and injection with real-time three-dimensional fluoroscopy guidance shows encouraging results as treatment for complex type II endoleaks after endovascular abdominal aortic aneurysm repair (EVAR).
van Bindsbergen
Lars
L
Department of Vascular Surgery, St Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.
Braak
Sicco J
SJ
van Strijen
Marco J L
MJ
de Vries
Jean-Paul P M
JP
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D003287:Contrast Media; D004621:Embolization, Therapeutic; D057867:Endoleak / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D057510:Endovascular Procedures / Q000009:adverse effects; D005471:Fluoroscopy; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D011677:Punctures; D011857:Radiographic Image Interpretation, Computer-Assisted; D015641:Radiography, Interventional / Q000379:methods*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D003287:Contrast Media