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Semin intervent Radiol 2015; 32(03): 259-264
DOI: 10.1055/s-0035-1556825
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of Endoleaks

James Chen
1   Division of Interventional Radiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
,
S. William Stavropoulos
1   Division of Interventional Radiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Publikationsdatum:
18. August 2015 (online)

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Abstract

The management of endoleaks remains an inherent challenge to endovascular aneurysm repair (EVAR), particularly as evolving techniques and devices have allowed treatment of increasingly complex aneurysm anatomy. Endovascular techniques are the favored modality for endoleak repair and include techniques to bridge the endoleak defector and embolize the endoleak nidus and inflow/outflow vessels. Conversion to surgical repair remains the definitive option in cases where less invasive methods have failed or are precluded. In this article, the authors review evidence on the indications, approach, and outcomes of current techniques for endoleak management.

Keywords

endovascular aneurysm repair - endoleak - embolization - interventional radiology
 

  • References

  • 1 Maldonado TS, Rosen RJ, Rockman CB , et al. Initial successful management of type I endoleak after endovascular aortic aneurysm repair with n-butyl cyanoacrylate adhesive. J Vasc Surg 2003; 38 (4) 664-670
    CrossrefPubMedGoogle Scholar
  • 2 Biasi L, Ali T, Hinchliffe R, Morgan R, Loftus I, Thompson M. Intraoperative DynaCT detection and immediate correction of a type Ia endoleak following endovascular repair of abdominal aortic aneurysm. Cardiovasc Intervent Radiol 2009; 32 (3) 535-538
    CrossrefPubMedGoogle Scholar
  • 3 Thomas BG, Sanchez LA, Geraghty PJ, Rubin BG, Money SR, Sicard GA. A comparative analysis of the outcomes of aortic cuffs and converters for endovascular graft migration. J Vasc Surg 2010; 51 (6) 1373-1380
    CrossrefPubMedGoogle Scholar
  • 4 Rajani RR, Arthurs ZM, Srivastava SD, Lyden SP, Clair DG, Eagleton MJ. Repairing immediate proximal endoleaks during abdominal aortic aneurysm repair. J Vasc Surg 2011; 53 (5) 1174-1177
    CrossrefPubMedGoogle Scholar
  • 5 Jordan Jr WD, Mehta M, Varnagy D , et al; Aneurysm Treatment using the Heli-FX Aortic Securement System Global Registry (ANCHOR) Workgroup Members. Results of the ANCHOR prospective, multicenter registry of EndoAnchors for type Ia endoleaks and endograft migration in patients with challenging anatomy. J Vasc Surg 2014; 60 (4) 885-92.e2
    CrossrefPubMedGoogle Scholar
  • 6 Golzarian J, Struyven J, Abada HT , et al. Endovascular aortic stent-grafts: transcatheter embolization of persistent perigraft leaks. Radiology 1997; 202 (3) 731-734
    CrossrefPubMedGoogle Scholar
  • 7 Choi SY, Lee Y, Lee KH , et al. Treatment of type I endoleaks after endovascular aneurysm repair of infrarenal abdominal aortic aneurysm: usefulness of N-butyl cyanoacrylate embolization in cases of failed secondary endovascular intervention. J Vasc Interv Radiol 2011; 22 (2) 155-162
    CrossrefPubMedGoogle Scholar
  • 8 Grisafi JL, Boiteau G, Detschelt E, Potts J, Kiproff P, Muluk SC. Endoluminal treatment of type IA endoleak with Onyx. J Vasc Surg 2010; 52 (5) 1346-1349
    CrossrefPubMedGoogle Scholar
  • 9 Chun JY, Morgan R. Transcatheter embolisation of type 1 endoleaks after endovascular aortic aneurysm repair with Onyx: when no other treatment option is feasible. Eur J Vasc Endovasc Surg 2013; 45 (2) 141-144
    CrossrefPubMedGoogle Scholar
  • 10 Rosen RJ, Green RM. Endoleak management following endovascular aneurysm repair. J Vasc Interv Radiol 2008; 19 (6, Suppl): S37-S43
    PubMedGoogle Scholar
  • 11 Dangas G, O'Connor D, Firwana B , et al. Open versus endovascular stent graft repair of abdominal aortic aneurysms: a meta-analysis of randomized trials. JACC Cardiovasc Interv 2012; 5 (10) 1071-1080
    PubMedGoogle Scholar
  • 12 Sidloff DA, Stather PW, Choke E, Bown MJ, Sayers RD. Type II endoleak after endovascular aneurysm repair. Br J Surg 2013; 100 (10) 1262-1270
    CrossrefPubMedGoogle Scholar
  • 13 Jones JE, Atkins MD, Brewster DC , et al. Persistent type 2 endoleak after endovascular repair of abdominal aortic aneurysm is associated with adverse late outcomes. J Vasc Surg 2007; 46 (1) 1-8
    CrossrefPubMedGoogle Scholar
  • 14 van Marrewijk C, Buth J, Harris PL, Norgren L, Nevelsteen A, Wyatt MG. Significance of endoleaks after endovascular repair of abdominal aortic aneurysms: the EUROSTAR experience. J Vasc Surg 2002; 35 (3) 461-473
    CrossrefPubMedGoogle Scholar
  • 15 Chaikof EL, Brewster DC, Dalman RL , et al; Society for Vascular Surgery. The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines. J Vasc Surg 2009; 50 (4, Suppl): S2-S49
    CrossrefPubMedGoogle Scholar
  • 16 Moll FL, Powell JT, Fraedrich G , et al; European Society for Vascular Surgery. Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery. Eur J Vasc Endovasc Surg 2011; 41 (1) (Suppl. 01) S1-S58
    CrossrefPubMedGoogle Scholar
  • 17 Keedy AW, Yeh BM, Kohr JR, Hiramoto JS, Schneider DB, Breiman RS. Evaluation of potential outcome predictors in type II Endoleak: a retrospective study with CT angiography feature analysis. AJR Am J Roentgenol 2011; 197 (1) 234-240
    CrossrefPubMedGoogle Scholar
  • 18 Parent FN, Meier GH, Godziachvili V , et al. The incidence and natural history of type I and II endoleak: a 5-year follow-up assessment with color duplex ultrasound scan. J Vasc Surg 2002; 35 (3) 474-481
    CrossrefPubMedGoogle Scholar
  • 19 Bargellini I, Napoli V, Petruzzi P , et al. Type II lumbar endoleaks: hemodynamic differentiation by contrast-enhanced ultrasound scanning and influence on aneurysm enlargement after endovascular aneurysm repair. J Vasc Surg 2005; 41 (1) 10-18
    CrossrefPubMedGoogle Scholar
  • 20 Arko FR, Filis KA, Siedel SA , et al. Intrasac flow velocities predict sealing of type II endoleaks after endovascular abdominal aortic aneurysm repair. J Vasc Surg 2003; 37 (1) 8-15
    CrossrefPubMedGoogle Scholar
  • 21 Stavropoulos SW, Park J, Fairman R, Carpenter J. Type 2 endoleak embolization comparison: translumbar embolization versus modified transarterial embolization. J Vasc Interv Radiol 2009; 20 (10) 1299-1302
    CrossrefPubMedGoogle Scholar
  • 22 Abularrage CJ, Patel VI, Conrad MF, Schneider EB, Cambria RP, Kwolek CJ. Improved results using Onyx glue for the treatment of persistent type 2 endoleak after endovascular aneurysm repair. J Vasc Surg 2012; 56 (3) 630-636
    CrossrefPubMedGoogle Scholar
  • 23 Khaja MS, Park AW, Swee W , et al. Treatment of type II endoleak using Onyx with long-term imaging follow-up. Cardiovasc Intervent Radiol 2014; 37 (3) 613-622
    CrossrefPubMedGoogle Scholar
  • 24 van Bindsbergen L, Braak SJ, van Strijen MJ, de Vries JP. Type II endoleak embolization after endovascular abdominal aortic aneurysm repair with use of real-time three-dimensional fluoroscopic needle guidance. J Vasc Interv Radiol 2010; 21 (9) 1443-1447
    CrossrefPubMedGoogle Scholar
  • 25 Stavropoulos SW, Carpenter JP, Fairman RM, Golden MA, Baum RA. Inferior vena cava traversal for translumbar endoleak embolization after endovascular abdominal aortic aneurysm repair. J Vasc Interv Radiol 2003; 14 (9, Pt 1): 1191-1194
    CrossrefPubMedGoogle Scholar
  • 26 Mansueto G, Cenzi D, Scuro A , et al. Treatment of type II endoleak with a transcatheter transcaval approach: results at 1-year follow-up. J Vasc Surg 2007; 45 (6) 1120-1127
    CrossrefPubMedGoogle Scholar
  • 27 Uthoff H, Katzen BT, Gandhi R, Peña CS, Benenati JF, Geisbüsch P. Direct percutaneous sac injection for postoperative endoleak treatment after endovascular aortic aneurysm repair. J Vasc Surg 2012; 56 (4) 965-972
    CrossrefPubMedGoogle Scholar
  • 28 Massis K, Carson III WG, Rozas A, Patel V, Zwiebel B. Treatment of type II endoleaks with ethylene-vinyl-alcohol copolymer (Onyx). Vasc Endovascular Surg 2012; 46 (3) 251-257
    CrossrefPubMedGoogle Scholar
  • 29 Gambaro E, Abou-Zamzam Jr AM, Teruya TH, Bianchi C, Hopewell J, Ballard JL. Ischemic colitis following translumbar thrombin injection for treatment of endoleak. Ann Vasc Surg 2004; 18 (1) 74-78
    CrossrefPubMedGoogle Scholar
  • 30 Baum RA, Carpenter JP, Cope C , et al. Aneurysm sac pressure measurements after endovascular repair of abdominal aortic aneurysms. J Vasc Surg 2001; 33 (1) 32-41
    CrossrefPubMedGoogle Scholar
  • 31 Lin JC, Eun D, Shrivastava A, Shepard AD, Reddy DJ. Total robotic ligation of inferior mesenteric artery for type II endoleak after endovascular aneurysm repair. Ann Vasc Surg 2009; 23 (2) 255.e19-255.e21
    PubMedGoogle Scholar
  • 32 Zhou W, Lumsden AB, Li J. IMA clipping for a type ii endoleak: combined laparoscopic and endovascular approach. Surg Laparosc Endosc Percutan Tech 2006; 16 (4) 272-275
    CrossrefPubMedGoogle Scholar
  • 33 Ling AJ, Pathak R, Garbowski M, Nadkarni S. Treatment of a large type II endoleak via extraperitoneal dissection and embolization of a collateral vessel using ethylene vinyl alcohol copolymer (Onyx). J Vasc Interv Radiol 2007; 18 (5) 659-662
    CrossrefPubMedGoogle Scholar
  • 34 Toya N, Fujita T, Kanaoka Y, Ohki T. Endotension following endovascular aneurysm repair. Vasc Med 2008; 13 (4) 305-311
    CrossrefPubMedGoogle Scholar
  • 35 Smith ST, Clagett GP, Arko FR. Endovascular conversion with femorofemoral bypass as a treatment of endotension and aneurysm sac enlargement. J Vasc Surg 2007; 45 (2) 395-398
    CrossrefPubMedGoogle Scholar
  • 36 Kougias P, Lin PH, Dardik A, Lee WA, El Sayed HF, Zhou W. Successful treatment of endotension and aneurysm sac enlargement with endovascular stent graft reinforcement. J Vasc Surg 2007; 46 (1) 124-127
    CrossrefPubMedGoogle Scholar