title: Improving the results of transarterial embolization of type 2 endoleaks with the embolic polymer Onyx.
abstract: BACKGROUND
  Type 2 endoleaks (T2E) occur in 10 to 20% of patients after endovascular abdominal aortic aneurysm repair (EVAR) and remain a significant clinical issue.
  
  
  OBJECTIVE
  To evaluate the efficacy and clinical outcomes of transarterial treatment of persistent type II endoleaks after EVAR using the liquid embolic Onyx.
  
  
  METHODS
  From February 2012 to August 2015 transarterial T2E embolization was attempted in 22 patients (21 men, median age: 73, range: 62-88 years). Indications for treatment included an increase in the diameter of the aneurysm sac above 5 mm and a persistent endoleak observed for more than 6 months. Mean time from EVAR to endoleak treatment was 43 months (range: 2-125 months).
  
  
  RESULTS
  Primary technical success was achieved in 17 (77.3%) patients and secondary technical success in 81.8%, with 0% in-hospital mortality. The mean procedure time was 95 ±48 min, with an average fluoroscopy time of 54 ±25 min. The mean amount of Onyx used was 7.5 ±6.6 ml. Clinical success was seen in 17/21 patients with follow-up imaging (80.9%). Mean follow-up time was 17 months (range: 3-38 months).
  
  
  CONCLUSIONS
  Onyx has been shown to effectively stabilize previous aneurysm growth as a result of the T2E in the majority of our patients. Transarterial embolization of T2E can be significantly improved as compared to previously reported results by using liquid embolic polymers such as Onyx.
authors.affiliation: 2 Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Mikolaj
authors.initials: M
authors.lastname: Wojtaszek
authors.affiliation: 2 Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Emilia
authors.initials: E
authors.lastname: Wnuk
authors.affiliation: 2 Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Rafal
authors.initials: R
authors.lastname: Maciag
authors.affiliation: Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Bohdan
authors.initials: B
authors.lastname: Solonynko
authors.affiliation: 2 Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Korzeniowski
authors.affiliation: 2 Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Lamparski
authors.affiliation: 2 Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Olgierd
authors.initials: O
authors.lastname: Rowinski
keywords: Onyx copolymer; aortic aneurysm; endoleak; therapeutic embolization