Ethylene-vinyl alcohol copolymer as embolic agent for treatment of type II endoleak: our experience.
OBJECTIVE
To evaluate safety, technical and clinical success of embolization of type II endoleak (T2 EL) using ethylene-vinyl alcohol copolymer as embolic agent alone or in combination with others materials.


METHODS
From March 2007 to March 2015, 104 patients presented T2 EL during follow-up. A total of 21 patients met the criteria for treatment. T2 EL was treated with TAE (n = 18), DPSI (n = 10) or laparoscopic ligature of the inferior mesenteric artery (n = 1). DPSI was considered in case TAE was unsuccessful (8/18 patients). Ethylene-vinyl alcohol copolymer was used as embolic agent in 12 patients: alone in 5 cases, in association with glue and with glue and thrombin in 3 and 2 cases, respectively, during TAE. Onyx was injected in two cases of embolization performed with DPSI: in one case alone and in the other in combination with thrombin and glue.


RESULTS
Technical success rate was 100%. Immediate clinical success was 91.7%; in one patient CEUS revealed persistent T2 EL, decreased if compared with that before the procedure. Secondary clinical success was 91.7%; until today, in one patient T2EL is persistent, nevertheless, the sac diameter remained stable. No major or minor complications were registered.


CONCLUSIONS
Onyx could be an ideal embolic agent for endovascular and percutaneous embolization of T2 EL.
Interventional Radiology, Department of Radiology, Insubria University, Viale Borri 57, 21100, Varese, VA, Italy.
Anna Maria
AM
Ierardi
Interventional Radiology, Department of Radiology, Insubria University, Viale Borri 57, 21100, Varese, VA, Italy.
Camilla
C
Micieli
Diagnostic and Interventional Radiology Unit, University of Milan, Viale di Rudinì 7, Milan, Italy.
Salvatore Alessio
SA
Angileri
Vascular Surgery Department, University of Insubria, Viale Borri 57, 21100, Varese, VA, Italy.
Nicola
N
Rivolta
Vascular Surgery Department, University of Insubria, Viale Borri 57, 21100, Varese, VA, Italy.
Gabriele
G
Piffaretti
Department of Radiology, "Luigi Sacco" University Hospital, Via G.B. Grassi 74, 20157, Milan, MI, Italy.
Massimo
M
Tonolini
Interventional Radiology, Department of Radiology, Insubria University, Viale Borri 57, 21100, Varese, VA, Italy.
Federico
F
Fontana
Department of Emergency Radiology, S. Camillo Hospital, Circonvallazione Gianicolense 87, 00152, Rome, Italy.
Vittorio
V
Miele
Department of Radiology, Università degli Studi del Molise, Campobasso, CB, Italy.
Luca
L
Brunese
Diagnostic and Interventional Radiology Unit, University of Milan, Viale di Rudinì 7, Milan, Italy. gcarraf@gmail.com.
Gianpaolo
G
Carrafiello
D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000379:methods; D057867:Endoleak / Q000000981:diagnostic imaging / Q000628:therapy*; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017537:Mesenteric Artery, Inferior; D008875:Middle Aged; D011145:Polyvinyls / Q000008:administration & dosage*; D012189:Retrospective Studies; D016896:Treatment Outcome
D011145:Polyvinyls; C020320:ethylene-vinyl alcohol copolymer
Embolization; Ethylene-vinyl alcohol copolymer; Onyx; Type II endoleak