Long-term outcomes of embolization of type II endoleaks

Abstract

Background

Type II endoleaks are common after endovascular aortic aneurysm repair. The purpose of this study was to assess the long-term outcomes of embolization of type II endoleaks using different techniques and materials.

Methods

Between 2003 and 2015, 31 patients underwent embolization of type II endoleaks, in a total of 41 procedures. Patients underwent transarterial or translumbar embolization using Onyx^®18, Onyx^®34, coils, Amplatzer® plug and/or thrombin. Embolization success was defined as no endoleak reintervention. The chi-square test and Fisher’s exact test were used for statistical analysis.

Results

Median embolization time after aortic aneurysm repair was 14 months. Fifteen (36%) embolization interventions were performed using Onyx^®18; seven (17%) with coils and Onyx^®34; six (14%) with Onyx^®34; four (10%) with coils and Onyx^® 18; four with Onyx^®18 and Onyx^®34; three (7%) with coils and thrombin; one (2%) with coils; and one (2%) with an Amplatzer® device. Eleven patients (35%) required reintervention. The embolization success rate was 71.43% (10) for patients with lumbar arteries as the source of the endoleak, 80% (8) for the inferior mesenteric artery and 40% (2) when both inferior mesenteric artery and lumbar arteries were the culprit vessels (p & 0.05). There was no statistically significant difference with regards to type of embolization, embolic material or type of previous aortic repair.

Conclusions

Endovascular treatment of type II endoleaks is challenging and reintervention is needed in up to 36% of patients. Endoleaks supplied by both the inferior mesenteric artery and the lumbar arteries have a lower rate of success.

Keywords:
type II endoleak; embolization; endoleak