title: Embolization for type 2 endoleak with sac expansion after endovascular repair of abdominal aortic aneurysm: safety and effectiveness.
abstract: To evaluate the safety and outcome of embolization as treatment for persistent type 2 endoleak (T2EL) occurring after abdominal aortic stent graft implantation. This retrospective study included seven consecutive patients (one female, six males, mean age 72 years, range 66-88 years) with T2EL between January 2011 and September 2012. In all, T2EL was associated with an increase more than 5 mm in the aneurysm. The endoleak cavity or feeding artery was embolized with coils and/or n-butyl cyanoacrylate. Clinical success was defined as regression or stabilization of the aneurysm sac irrespective of residual endoleaks on follow-up CT studies. At the time of T2EL intervention, mean aneurysm sac diameter was 63 mm (range 52-72 mm), and mean increase size of aneurysm sac diameter was 7 mm (range 5-13). Mean follow-up period was 6.0 ± 6.2 months (range 3-18 months). Our technical success rate was 100 %. Clinical success was obtained in 5 (71.4 %) of the seven patients. One patient was embolized three times due to sac expansion. T2EL was treated by transarterial embolization in eight procedures, and one procedure was performed by direct puncture embolization. There were no major complications; two procedures elicited minor complications: transient back pain and muscle weakness of the left lower leg. We suggest embolization was safe and effective treatment, a less invasive treatment option comparison to open repair, as one choice to address T2EL.
authors.affiliation: Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kajiwara
authors.affiliation: Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Yamagami
authors.affiliation: Diagnostic Radiology, Hiroshima City Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518 Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Urashima
authors.affiliation: Radiology, Higashihiroshima Medical Center, 513 Saijyou-tyo, Hiroshima, 739-0041 Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Tomiyoshi
authors.affiliation: Radiology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6, Senda-machi, Naka-ku, Hiroshima, 730-8619 Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kakizawa
authors.affiliation: Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Yoshimatsu
authors.affiliation: Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Ishikawa
authors.affiliation: Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
keywords: Embolization; Endovascular aneurysm repair; Interventional; Type 2 endoleak; Vascular