title: Transcaval embolization as an alternative technique for the treatment of type II endoleak after endovascular aortic aneurysm repair.
abstract: The purpose of this report is to highlight our experience with transcaval embolization (TCE) for the management of type II endoleaks (T2Es) as well as to provide a technical description of how to improve procedural safety and success. All patients underwent transfemoral venous access with transcaval puncture into the excluded aneurysm sac with coil placement and selective thrombin injection. Six patients (100% male; mean age [standard deviation] 72.7 [10.8] years) underwent TCE. Technical success was 100% with no postoperative complications. At median follow-up of 8.1 months (range, 2-22 months), two patients had persistent T2Es, with one requiring repeat TCE and the other having cessation of aneurysm growth. The TCE provides a practical alternative to transarterial or translumbar access for the management of T2E, with high degrees of technical and clinical success in this small case series. Larger patient numbers and longer-term follow-up are needed to define procedural efficacy and durability.
authors: Division of Vascular Surgery and Endovascular Therapy, University of Florida College of Medicine, Gainesville, FL, USA. salvatore.scali@surgery.ufl.edu
authors: Salvatore T
authors: ST
authors: Scali
authors: Adrian
authors: A
authors: Vlada
authors: Catherine K
authors: CK
authors: Chang
authors: Adam W
authors: AW
authors: Beck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D057867:Endoleak / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D005268:Femoral Vein; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D011677:Punctures; D013917:Thrombin / Q000008:administration & dosage; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging
chemical_list: D013917:Thrombin