title: Safety and efficacy of embolization using Onyx®of persistent type II endoleaks after abdominal endovascular aneurysm repair.
abstract: OBJECTIVE
  To retrospectively evaluate the safety and efficacy of embolization of persistent type II endoleaks occurring after abdominal endovascular aneurysm repair (EVAR) using ethylene vinyl alcohol copolymer (Onyx®).
  
  
  METHODS
  Between 2008 and 2016, 28 consecutives patients (25 men, 3 women) with a mean age of 75.3years±9 (SD) (range: 59-90years) were treated for 29 persistent type II endoleaks with increasing aneurysm size>5mm occurring after EVAR. A total of 35 embolization procedures were performed using Onyx®, via a transarterial route (n=25) or direct puncture (n=10), with or without additional metallic coils. The endpoints were to evaluate the clinical efficacy, corresponding to the stabilization or decrease of aneurism size, and the technical efficacy, corresponding to the ability to complete the embolization.
  
  
  RESULTS
  No severe complications were observed during and after embolization. The primary and secondary clinical efficacies were 75% (21/28) and 96.4% (27/28), respectively. Overall primary technical efficacy rate was 58.6% (17/29), greater for transarterial technique (72.8%) than for direct puncture (14.3%) (P=0.01). Secondary technical efficacy was 72.4% (21/29), with no differences between transarterial (81.8%) and direct puncture (42.8%) (P=0.06).
  
  
  CONCLUSIONS
  Embolization with Onyx®of type II endoleaks after EVAR appears a safe and effective procedure.
authors.affiliation: Department of radiology, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux, France. Electronic address: clement.marcelin@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Marcelin
authors.affiliation: Department of radiology, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Le Bras
authors.affiliation: Department of radiology, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux, France.
authors.forename: F
authors.initials: F
authors.lastname: Petitpierre
authors.affiliation: Department of vascular surgery, groupe hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France.
authors.forename: D
authors.initials: D
authors.lastname: Midy
authors.affiliation: Department of vascular surgery, groupe hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France.
authors.forename: E
authors.initials: E
authors.lastname: Ducasse
authors.affiliation: Department of radiology, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux, France.
authors.forename: N
authors.initials: N
authors.lastname: Grenier
authors.affiliation: Department of radiology, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux, France.
authors.forename: F
authors.initials: F
authors.lastname: Cornelis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000628:therapy*; D000072226:Computed Tomography Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D057867:Endoleak / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls; D015641:Radiography, Interventional; D012189:Retrospective Studies
chemical_list: D011145:Polyvinyls; C020320:ethylene-vinyl alcohol copolymer
keywords: Abdominal aneurysm; Abdominal endovascular aneurysm repair (EVAR); Embolization; Endoleak; Interventional radiology