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- W2000267336 abstract "The increase of endovascular aortic repair (EVAR) has been accompanied by a consequent increase in Type II endoleaks. This study reports our experience with transcaval coil embolization (TCCE), a novel strategy to treat this complication. We reviewed 24 consecutive patients undergoing TCCE from 2010 to 2013. Demographics, operative details, and outcomes were assessed. Since 2006, over 450 EVARs have been performed at our institution with 24 TCCE performed in 22 patients for sac expansion from Type II endoleaks. Patients were male (87%) former or current smokers (87%) with an average age of 78 (±7.2) years. TCCE was performed a mean of 4.2 (±4) years after initial EVAR (21% for rupture). Endoleaks resulted in a mean sac growth of 1.2 (±0.9) cm diameter and 38% ± 35% volume. Forty-two percent had failed prior procedures (five translumbar, two transcaval, two aortic cuff, two internal iliac branch embolization, and one fenestrated branched endograft). Two patients had ultimate sac access between the endograft iliac limb and arterial wall after transcaval puncture failed with an overall 87% technical success (79% for transcaval technical success). Mean fluoroscopy time was 28 (±14) minutes with 29 (±22) mL contrast used and mean 9.7 coils per case. Additional adjuncts included thrombin injection (21%), intravascular ultrasound (13%), sac pressure measurements (29%), and on table integrated computed tomography (17%). Median length of stay was 1 day (range, 0-5 days). Reintervention was required in four cases (two repeat TCCE, one open sac plication, one branched fenestrated endograft for proximal degeneration). On last follow-up, 77% experienced no further leak and stable sac diameters, 9% had continued endoleak with sac expansion, and 14% are awaiting follow-up imaging. There have been no ruptures during follow-up. TCCE is a safe technique which provides another option for treatment of aneurysm enlargement due to Type II endoleaks." @default.
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- W2000267336 date "2013-09-01" @default.
- W2000267336 modified "2023-09-28" @default.
- W2000267336 title "Results of Transcaval Embolization for Sac Expansion from Type II Endoleaks After EVAR" @default.
- W2000267336 doi "https://doi.org/10.1016/j.jvs.2013.06.031" @default.
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