PDF herunterladen
Int J Angiol 2016; 25(05): e169-e172
DOI: 10.1055/s-0036-1593826
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Safety of Using Large Amount (30 cc) of Onyx (Ethylene-vinyl Alcohol Copolymer) for the Treatment of Large Type II Endoleak after Endovascular Repair of Abdominal Aortic Aneurysm

Mohammad Hasan Namazi
1   Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
Isa Khaheshi
1   Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
Ali Reza Serati
1   Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
Mohammad Reza Movahed
2   CareMore, Tucson, Arizona
3   Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
15. Dezember 2016 (online)

    Lizenzen und Reprints

Abstract

Endovascular aneurysm repair (EVAR) is associated with late complications including the development of endoleaks as major complications. Type II endoleak is the consequence of collateral retrograde flow from the aortic branches; generally from the lumbar arteries, inferior mesenteric artery, or middle sacral artery. The method and the ideal timing for the treatment of endoleaks remain controversial. We are presenting a case of successful treatment of a large type II endoleak using embolization with large amount of Onyx copolymer via a percutaneous transfemoral route without any adverse outcome. A significant advantage of Onyx as opposed to glue is that it may be injected for a long period of time (20–60 minutes) with a lower risk for microcatheter entrapment. This case report suggests that much higher amount of Onyx can safely be used if needed to seal large endoleaks without adverse event.

Keywords

endoleak - transcatheter intervention - aortic aneurysm - complications - stenting - aortic endograft - endovascular aneurysm repair - aneurysmal abdominal aorta
 

  • References

  • 1 Hölzenbein TJ, Kretschmer G, Thurnher S , et al. Midterm durability of abdominal aortic aneurysm endograft repair: a word of caution. J Vasc Surg 2001; 33 (2, Suppl) S46-S54
    CrossrefPubMedGoogle Scholar
  • 2 Alric P, Hinchliffe RJ, Wenham PW, Whitaker SC, Chuter TA, Hopkinson BR. Lessons learned from the long-term follow-up of a first-generation aortic stent graft. J Vasc Surg 2003; 37 (2) 367-373
    CrossrefPubMedGoogle Scholar
  • 3 Chuter TA, Faruqi RM, Sawhney R , et al. Endoleak after endovascular repair of abdominal aortic aneurysm. J Vasc Surg 2001; 34 (1) 98-105
    CrossrefPubMedGoogle Scholar
  • 4 Lee K, Forbes TL. Current understanding of the significance and treatment of type II endoleaks. Ital J Vasc Endovasc Surg 2012; 19 (4) 191-197
    PubMedGoogle Scholar
  • 5 Rhee SJ, Ohki T, Veith FJ, Kurvers H. Current status of management of type II endoleaks after endovascular repair of abdominal aortic aneurysms. Ann Vasc Surg 2003; 17 (3) 335-344
    CrossrefPubMedGoogle Scholar
  • 6 Maldonado TS, Gagne PJ. Controversies in the management of type II “branch” endoleaks following endovascular abdominal aortic aneurysm repair. Vasc Endovascular Surg 2003; 37 (1) 1-12
    CrossrefPubMedGoogle Scholar
  • 7 Faries PL, Cadot H, Agarwal G, Kent KC, Hollier LH, Marin ML. Management of endoleak after endovascular aneurysm repair: cuffs, coils, and conversion. J Vasc Surg 2003; 37 (6) 1155-1161
    CrossrefPubMedGoogle Scholar
  • 8 Nevala T, Biancari F, Manninen H , et al. Type II endoleak after endovascular repair of abdominal aortic aneurysm: effectiveness of embolization. Cardiovasc Intervent Radiol 2010; 33 (2) 278-284
    CrossrefPubMedGoogle Scholar
  • 9 Boks SS, Andhyiswara T, de Smet AA, Vroegindeweij D. Ultrasound-guided percutaneous transabdominal treatment of a type 2 endoleak. Cardiovasc Intervent Radiol 2005; 28 (4) 526-529
    CrossrefPubMedGoogle Scholar
  • 10 Kasthuri RS, Stivaros SM, Gavan D. Percutaneous ultrasound-guided thrombin injection for endoleaks: an alternative. Cardiovasc Intervent Radiol 2005; 28 (1) 110-112
    CrossrefPubMedGoogle Scholar
  • 11 Ellis PK, Kennedy PT, Collins AJ, Blair PH. The use of direct thrombin injection to treat a type II endoleak following endovascular repair of abdominal aortic aneurysm. Cardiovasc Intervent Radiol 2003; 26 (5) 482-484
    PubMedGoogle Scholar
  • 12 Bosiers MJ, Schwindt A, Donas KP, Torsello G. Midterm results of the transarterial use of Onyx in the treatment of persisting type II endoleaks after EVAR. J Cardiovasc Surg (Torino) 2013; 54 (4) 469-475
    PubMedGoogle Scholar
  • 13 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
  • 14 Zarins CK, White RA, Hodgson KJ, Schwarten D, Fogarty TJ. Endoleak as a predictor of outcome after endovascular aneurysm repair: AneuRx multicenter clinical trial. J Vasc Surg 2000; 32 (1) 90-107
    CrossrefPubMedGoogle Scholar
  • 15 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