[DJR-125 1.0 CE] Transabdominal Direct Sac Puncture Embolization of Type II Endoleaks after Endovascular Abdominal Aortic Aneurysm


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Purpose: To determine the efficacy and safety of transabdominal direct sac puncture embolization of type II endoleaks after endovascular
abdominal aortic aneurysm repair (EVAR).

Materials and Methods: This retrospective review included 30 patients (4 women, 26 men; mean age ¼ 79.1 years) who underwent 33 transabdominal direct sac puncture embolization procedures for type II endoleaks after EVAR. Embolization agents included cyanoacrylate glue only (45.5%), glue/coils (36.4%), and Onyx with or without glue/coils (18.1%). Technical success was defined as complete endoleak embolization on intraprocedural fluoroscopy. The primary outcome was freedom of aneurysm growth, which was defined as  5% aneurysm sac volume change on follow-up computed tomography (CT) imaging or  5 mm aneurysm sac diameter change on ultrasound without definite endoflow. Aneurysm sac volumes before and after embolization were manually segmented from CT images. The procedural complication rate was calculated.

Results: Technical success was achieved in 97% of patients (29/30). Follow-up imaging was available in 27 patients (25 CT; 2 ultrasound), and mean imaging follow-up duration was 15.5 months. Freedom of aneurysm growth was achieved in 85.2% of patients (23/27) after 1 or more embolization procedures. Median fluoroscopic and procedure times were 11.3 minutes and 90 minutes, respectively.
The complication rate was 9.1% (3/33) and included 1 case of nontarget embolization with transient neuropraxia and 2 self-limiting rectus sheath hematomas relating to the percutaneous puncture site. No aneurysm-related mortality occurred during the follow-up period.

Conclusions: Percutaneous transabdominal embolization is a safe and efficacious treatment for type II endoleak, with a short procedure time.

VI – 2016Procedures
Abdominal Angiography and Intervention, GU and GI Nonvascular Procedures1.00
VI – 2017Procedures
Vascular Interventional Procedures1.00