title: Experience of direct percutaneous sac injection in type II endoleak using cone beam computed tomography.
abstract: Cone beam CT, usually used in dental area, could easily obtain 3-dimensional images using cone beam shaped ionized radiation. Cone beam CT is very useful for direct percutaneous sac injection (DPSI) which needs very precise measurement to avoid puncture of inferior vena cava or vessel around sac or stent graft. Here we describe two cases of DPSI using cone beam CT. In case 1, a 79-year-old male had widening of preexisted type II endoleak after endovascular aneurysm repair (EVAR). However, transarterial embolization failed due to tortuous collateral branches of lumbar arteries. In case 2, a 72-year-old female had symptomatic sac enlargement by type II endoleak after EVAR. However, there was no route to approach the lumbar arteries. Therefore, we performed DPSI assisted by cone beam CT in cases 1, 2. Six-month CT follow-up revealed no sign of sac enlargement by type II endoleak.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Yoong-Seok
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Do
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hong Suk
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Kwang Bo
authors.initials: KB
authors.lastname: Park
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Dong-Ik
authors.initials: DI
authors.lastname: Kim
keywords: Cone beam computed tomography; Endoleak; Endovascular procedures; Therapeutic embolization
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