title: Comparison of Type II Endoleak Embolizations: Embolization of Endoleak Nidus Only versus Embolization of Endoleak Nidus and Branch Vessels.
abstract: OBJECTIVE
  To compare outcomes of type II endoleak embolization involving embolization of the endoleak nidus only vs embolization of the endoleak nidus and branch vessels in patients treated with endovascular repair of abdominal aortic aneurysms.
  
  
  METHODS
  Twenty-nine consecutive patients (mean age, 77.9 y; range, 63-88 y) with type II endoleak who underwent embolization from 2004 to 2015 were retrospectively reviewed. Patients were divided into 2 groups: embolization of endoleak nidus only (group A) and embolization of endoleak nidus and branch vessels (group B). Mean follow-up intervals were 20.5 months ± 14.7 in group A and 24.3 months ± 18.5 in group B. Outcomes were compared between groups by Mann-Whitney U and Pearson χ2tests.
  
  
  RESULTS
  Mean interval from endovascular aneurysm repair to embolization was 47.6 months ± 42.9, and mean presentation time of endoleak before embolization was 23.1 months ± 25.8. Coils (n = 28) and liquid embolic agents (n = 23) were used for embolization. There were no significant differences in rates of residual endoleak (50% vs 53.8%; P = .96) or sac decrease/stabilization (62.5% vs 61.5%; P = .64). Procedure time and radiation exposure in group B (132.3 min ± 78.1; 232.4 Gy·cm2± 130.7) were greater than in group A (63.4 min ± 11.9; 61.5 Gy·cm2± 35.5; P < .01). There were no procedure-related complications.
  
  
  CONCLUSIONS
  Embolization of the endoleak nidus and branch vessels is not superior to embolization of only the nidus in terms of occlusion of type II endoleak and change in sac size despite requiring longer procedure times and resulting in greater patient radiation exposure.
authors.affiliation: Division of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: hyeon_yu@med.unc.edu.
authors.forename: Hyeon
authors.initials: H
authors.lastname: Yu
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Hemant
authors.initials: H
authors.lastname: Desai
authors.affiliation: Division of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Ari J
authors.initials: AJ
authors.lastname: Isaacson
authors.affiliation: Division of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Dixon
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Farber
authors.affiliation: Division of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Charles T
authors.initials: CT
authors.lastname: Burke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography; 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; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D000069079:Radiation Exposure; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome