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This single-center study investigated the safety and efficacy of transarterial embolization of type II endoleaks for expanding aneurysm sacs following endovascular aortic repair (EVAR).36 patients (33 men, 75.9±6.6 years) underwent a total of 50 endovascular procedures for type II endoleak embolization between 2008 and 2023. Analyses included the assessment of patient risk profiles, aneurysm morphology, and endoleak characteristics. Outcome parameters comprised the technical success (i.e., complete lack of blood flow in the previously perfused aneurysm sac) and complication rates, while clinical success was defined as the absence of endoleak persistence or recurrence and freedom from aneurysm enlargement > 0.5 cm over the follow-up period.Transarterial embolization was technically successful in 84% of procedures with a complication rate of 2%. Most interventions were coil-based (72%), while a small number relied solely on liquid embolic agents (14%). Absence of a persisting endoleak in the earliest follow-up could be demonstrated in 75.6% of cases, whereas the absence rate for endoleak recurrence was substantially lower (46.3%). No aneurysm enlargement > 0.5 cm during follow-up was ascertained after 73.2% of interventions.Transarterial embolization represents a safe treatment for type II endoleaks after EVAR. While embolization was moderately effective in preventing further expansion of aneurysms due to endoleak recurrence, most procedures were successful in permanently eliminating the targeted feeder vessels. · Transarterial embolization of type II endoleaks has a high technical success rate.. · The emergence of new feeder vessels may necessitate multiple procedures over time.. · Patient risk profiles did not factor into the clinical outcome.. · Krompaß K, Grunz JP, Augustin AM et al. Technical and clinical success analysis of transarterial embolization therapy in type II endoleaks following endovascular aortic repair. Fortschr Röntgenstr 2024; DOI 10.1055/a-2384-4601.
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http://dx.doi.org/10.1055/a-2384-4601 | DOI Listing |
Interv Radiol (Higashimatsuyama)
April 2025
Department of Radiology, Sumitomo Hospital, Japan.
Endoleak is a significant complication of endovascular aortic repair, associated with adverse long-term outcomes. This review discusses the classification, mechanisms, and imaging diagnosis of endoleaks. Five types of endoleaks are described, each with distinct characteristics and management approaches.
View Article and Find Full Text PDFInterv Radiol (Higashimatsuyama)
April 2025
Department of Radiology, National Cerebral and Cardiovascular Center, Japan.
Type II endoleak is the most common complication after endovascular abdominal aortic aneurysm repair. Type II endoleak with aneurysm sac growth is not benign for long-term outcomes of endovascular abdominal aortic aneurysm repair and should be treated to prevent secondary stent graft-related complications and aneurysm rupture. The current consensus is to consider treatments for persistent type II endoleak with significant aneurysm sac growth.
View Article and Find Full Text PDFInterv Radiol (Higashimatsuyama)
April 2025
Department of Diagnostic and Interventional Radiology, Kobe University Hospital, Japan.
Preemptive side branch embolization may help prevent type II endoleak, reduce reintervention rates, and promote early aneurysm sac shrinkage after endovascular aneurysm repair. However, evidence of its effectiveness in preventing aneurysm rupture, reducing aneurysm-related mortality, ensuring safety, and maintaining cost-effectiveness is limited. The 2024 European Society for Vascular Surgery guidelines do not recommend routine preemptive embolization due to a lack of high-quality evidence.
View Article and Find Full Text PDFAnn Vasc Surg
September 2025
Division of Vascular and Endovascular Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Brazil.
Background: To compare the results of internal iliac artery (IIA) incorporation using balloon-expandable (BESG) versus self-expandable stent grafts (SESG) while using iliac branch devices (IBD) for endovascular repair of aorto-iliac artery aneurysms.
Methods: A systematic review and meta-analysis was conducted. PubMed, Embase, and Cochrane databases were searched for studies up to December 2024 that compared BESG and SESG for IBD during endovascular repair of aortoiliac aneurysms.
Surg Case Rep
August 2025
Department of Cardiovascular Surgery, National Hospital Organization Obihiro Hospital, Obihiro, Hokkaido, Japan.
Introduction: There are many reports of late open conversion after endovascular aortic repair (EVAR). Herein, we report the case of an octogenarian patient with a giant ovarian tumor who underwent ovarian tumor resection and open conversion with graft replacement simultaneously via laparotomy.
Case Presentation: An 86-year-old woman underwent EVAR 7 years ago.