A procedural step analysis of radiation exposure in fenestrated endovascular aortic repair

Rockley, Mark; Nana, Petroula; Rebet, Aya; Fabre, Dominique; Haulon, Stéphan

doi:10.1016/j.jvs.2024.02.006

Cited by 1 publication

(2 citation statements)

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“…Pre-emptive embolization to prevent EL 2 has been applied with encouraging outcomes, including significantly lower rates of sac expansion and EL 2-related reinterventions [ 32 ]. However, data on cost-effectiveness, radiation exposure, and incidence of aortic rupture are limited or completely lacking [ 10 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

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Early and Mid-Term Outcomes of Transcaval Embolization for Type 2 Endoleak after Endovascular Aortic Repair

Nana,

Panuccio,

Rohlffs

et al. 2024

JCM

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Background: Among the endovascular approaches for the management of endoleak type 2 (EL 2), transcaval embolization (TCE) has shown encouraging outcomes. However, the literature is still limited. This study aimed to present the early and mid-term outcomes of TCE for EL 2 after endovascular aortic repair. Methods: A retrospective, single-center analysis of consecutive patients managed with TCE for EL 2 after standard or complex endovascular aortic repair, from August 2015 to March 2024, was conducted. The indication for TCE was the presence of an EL 2 related to ≥5 mm sac increase, compared to the first imaging after aneurysm exclusion or the smallest diameter during follow-up. Patients managed with TCE for other types of endoleaks were excluded. The primary outcomes were technical and clinical successes during follow-up. Results: Forty-three patients were included (mean age: 75.1 ± 6.0 years, 90.7% males). Technical success was 97.7%. Selective embolization was performed in 48.8% and non-selective in 51.2%. No death was recorded at 30 days. The estimated clinical success was 90.0% (standard error; SE: 6.7%) and the freedom from EL 2 was 89.0% (SE 6.4%) at 36 months. Cox regression analysis showed that the type of embolization (selective vs. non-selective), type of previous repair (f/bEVAR vs. EVAR), and use of anticoagulants did not affect follow-up outcomes. Reinterventions related to EL 2 were performed in 12.5%; three underwent an open conversion. Conclusions: TCE was related to high technical success and limited peri-operative morbidity, regardless of the type of initial endovascular aortic repair. Clinical success was encouraging with reinterventions for EL 2 affecting 12.5% of patients.

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Section: Discussionmentioning

confidence: 99%

“…Selective pre-emptive embolization has also shown encouraging outcomes [ 9 ]. However, radiation exposure during this step should be considered [ 10 ]. Other approaches, including trans-endograft and transcaval embolization (TCE) have been also successfully applied [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%