title: Treatment of type I endoleaks after endovascular aneurysm repair of infrarenal abdominal aortic aneurysm: usefulness of N-butyl cyanoacrylate embolization in cases of failed secondary endovascular intervention.
abstract: OBJECTIVE
  To evaluate the technical feasibility and effectiveness of N-butyl cyanoacrylate (NBCA) embolization using a percutaneous transabdominal or a transarterial approach in the failed secondary endovascular treatment of type I endoleaks after endovascular aneurysm repair (EVAR) of infrarenal abdominal aortic aneurysms.
  
  
  METHODS
  From 2000-2007, seven patients with failed secondary endovascular treatment of type I endoleaks (five patients with type Ia endoleak, one patient with type Ib endoleak, and one patient with type Ia and Ib endoleaks) were treated with embolization using NBCA with or without a coil. Embolizations were performed using either a percutaneous transabdominal (n = 5) or a transarterial (n = 5) approach. Four patients underwent a single session of embolization, and three underwent two sessions of embolization. The duration between EVAR and endoleak treatment was 9.6 months ± 15.3 (mean ± standard deviation; range 0-42 months). Follow-up computed tomography (CT) scans were evaluated for changes in size and shape of the aneurysm sac and presence or resolution of endoleaks. The follow-up period after endoleak treatment was 18.0 months ± 20.4 (mean ± standard deviation; range 0-53 months).
  
  
  RESULTS
  Technical success was achieved in six patients with complete resolution of the endoleak confirmed by follow-up CT scans. One technical failure was observed in a patient who eventually underwent surgical conversion. There were no procedure-related complications.
  
  
  CONCLUSIONS
  Embolization with NBCA by a percutaneous transabdominal or a transarterial approach for the treatment of type I endoleaks after EVAR was technically feasible and clinically effective, with no major complications.
authors.affiliation: Department of Radiology, Hallym University Sacred Heart Hospital, College of Medicine, Gyonggi-do, South Korea.
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Choi
authors.forename: Do Yun
authors.initials: DY
authors.lastname: Lee
authors.forename: Kwang-Hun
authors.initials: KH
authors.lastname: Lee
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Won-Heum
authors.initials: WH
authors.lastname: Shim
authors.forename: Jong Yun
authors.initials: JY
authors.lastname: Won
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000627:therapeutic use*; D057867:Endoleak / Q000209:etiology* / Q000628:therapy*; D057510:Endovascular Procedures / Q000009:adverse effects*; D005240:Feasibility Studies; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics; D004659:Enbucrilate