title: Transcatheter transcaval embolization of a type II endoleak after EVAR using a transseptal needle-sheath system.
abstract: OBJECTIVE
  The purpose of this study is to present an alternative technique for management of a type II endoleak associated with aneurysm sac enlargement.
  
  
  METHODS
  We report the use of a transseptal needle-sheath system for a transcatheter transcaval embolization (TTE) in a 3-staged treatment of a persistent type II endoleak after abdominal EVAR. Inferior vena cava is cannulated through a femoral venous access, and aneurysmal sac access is gained with a puncture through the walls of the 2 vessels at the site where the vein is adjacent to the aneurysm. The whole system (sheath-dilator-needle) is then advanced across the vascular walls into the aortic sac. Thus, embolization with glue is performed.
  
  
  CONCLUSIONS
  The TTE using a transseptal needle-sheath system demonstrated to be feasible and effective to treat a persistent type II endoleak after failure of 2 attempts of transarterial embolization of the feeding vessels.
authors.affiliation: Cardiovascular and Interventional Radiology, Hôpital Cardiologique, CHRU de Lille, France.
authors.forename: Marco
authors.initials: M
authors.lastname: Midulla
authors.forename: Paolo
authors.initials: P
authors.lastname: Perini
authors.forename: Ramanivas
authors.initials: R
authors.lastname: Sundareyan
authors.forename: Younes
authors.initials: Y
authors.lastname: Lazguet
authors.forename: Aurelie
authors.initials: A
authors.lastname: Dehaene
authors.forename: Gilles
authors.initials: G
authors.lastname: Goyault
authors.forename: Thomas
authors.initials: T
authors.lastname: Martinelli
authors.forename: Stéphan
authors.initials: S
authors.lastname: Haulon
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D002405:Catheterization, Central Venous / Q000295:instrumentation / Q000379:methods; D057785:Catheters; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D004659:Enbucrilate / Q000008:administration & dosage; D057867:Endoleak / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005268:Femoral Vein / Q000000981:diagnostic imaging; D006801:Humans; D015552:Injections, Intralesional; D007459:Iodized Oil / Q000008:administration & dosage; D008297:Male; D009339:Needles; D011475:Prosthesis Failure; D011677:Punctures; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging
chemical_list: D007459:Iodized Oil; D004659:Enbucrilate