title: Transcatheter Embolisation of Proximal Type 1 Endoleaks Following Endovascular Aneurysm Sealing (EVAS) Using the Nellix Device: Technique and Outcomes.
abstract: OBJECTIVE
  To evaluate the technical success and mid-term outcomes following transcatheter embolisation of type 1a endoleak after Nellix endovascular aneurysm sealing (EVAS).
  
  
  METHODS
  Seven patients (5 men; mean age 83; range 79-90) underwent transcatheter embolisation between July 2013 and August 2014. The average time from EVAS to embolisation was 136 days (range 6-301) and from endoleak diagnosis to embolisation was 20 days (range 2-50). Embolisation was performed with coils and Onyx in six cases and Onyx only in one case. Technical success, imaging and clinical outcomes of embolisation were reviewed. Technical success was defined as elimination of the endoleak on completion angiography and first imaging follow-up. Clinical success was defined as unchanged or decreased aneurysm sac size on subsequent follow-up (average 8 months; range 103-471 days).
  
  
  RESULTS
  All cases were technically successful. One patient required a second endovascular procedure following Onyx reflux into the Nellix endograft and another patient required surgical closure of a brachial puncture site. All patients are endoleak free with stable sac size on the latest available follow-up imaging.
  
  
  CONCLUSIONS
  If a type 1 endoleak occurs after EVAS, embolisation using Onyx with or without coils is feasible and effective with high technical success and freedom from endoleak recurrence at mid-term follow-up.
authors.affiliation: Department of Radiology, St George's Hospital, Blackshaw Road, London, SW17 0QT, UK. seyedameli@doctors.org.uk.
authors.forename: S
authors.initials: S
authors.lastname: Ameli-Renani
authors.affiliation: Department of Radiology, St George's Hospital, Blackshaw Road, London, SW17 0QT, UK. Robert.morgan@stgeorges.nhs.uk.
authors.forename: R A
authors.initials: RA
authors.lastname: Morgan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery*; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use; D004621:Embolization, Therapeutic / Q000379:methods / Q000706:statistics & numerical data*; D057867:Endoleak / Q000150:complications / Q000628:therapy*; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011145:Polyvinyls / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide
keywords: Abdominal aortic aneurysm; Aorta; Embolisation; Endovascular aortic aneurysm; Transcatheter arterial embolisation