Laser-Assisted Transgraft Embolization: A Technique for the Treatment of Type II Endoleaks

Mewissen, Mark W.; Jan, M. Fuad; Kuten, David; Krajcer, Zvonimir

doi:10.1016/j.jvir.2017.07.029

Cited by 15 publications

(13 citation statements)

References 14 publications

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“…Embolization with liquid embolics alone may increase a risk of undesired distal embolization, which could lead to paralysis. 5 , 6 , 7 , 8 , 9 Ironically, embolization with both coils and NBCA may compromise the ability of a contrast-enhanced CT scan to detect potential endoleak owing to halation. Fluoroscopic angiography of the nidus during the TGE could identify type I endoleaks, as well as endoleaks from the vasa vasorum and arteriovenous fistula, which might not be detectable with contrast-enhanced CT scans.…”

Section: Discussionmentioning

confidence: 99%

“…There are only limited number of case reports regarding transgraft embolization (TGE). 5 , 6 , 7 , 8 In those cases, TGEs were performed with a coronary laser catheter, 6 , 7 Brockenbrough needle (BRK), 8 or transjugular liver access set 6 ; therefore, procedures were not consistent. Since 2013, we applied TGE to evaluate the efficacy of TGE for treatment of T2E when TAE was in technical difficulties (there are no vessels that can be evaluated by computed tomography [CT] images and TAE was unsuccessful).…”

mentioning

confidence: 99%

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Transgraft embolization by using long needle for the treatment of type II endoleaks after endovascular abdominal aortic repair

Matsumura

Wada

Teratani

et al. 2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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We used a long custom needle (LCN) to improve transgraft embolization (TGE) in 10 reported cases that underwent TGE with LCN for type II endoleak (T2E) treatment after endovascular abdominal aortic aneurysm repair. TGE was performed with a LCN enabling the usage of microcatheter and embolization coils in 10 cases with T2E after endovascular abdominal aortic aneurysm repair. Embolization was successfully achieved in the nidus in all 10 cases. The aneurysmal sac diameter significantly decreased by TGE, and none of the 7 of 10 cases exhibited recurrence of sac expansion or T2E throughout the 2-year follow-up period.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Transgraft embolization by using long needle for the treatment of type II endoleaks after endovascular abdominal aortic repair

Matsumura

Wada

Teratani

et al. 2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…For the sake of completeness, alternative but rarely indicated pathways to the endoleak are mentioned here: Transcaval access [35][36][37], peri-and transgraft access [38,39], and transosseous access [40].…”

Section: Direct Percutaneous Puncturementioning

confidence: 99%

Embolization of Type 2 Endoleaks in the Abdominal Aorta Using Ethylene Vinyl Alcohol Copolymer

Nolte-Ernsting¹,

Mecklenbeck²,

Stehr³

2021

Rofo

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Background Type 2 endoleaks (T2EL) are the most frequent complication following endovascular aortic repair. Multiple studies primarily deal with the technical and clinical success of the embolization of persisting T2EL, thereby revealing controversial outcomes. Current reports rarely focus on the detailed execution of such a complex interventional procedure with respect to the difficult anatomic setting. Methods The present review provides an in-depth depiction and evaluation of the interventional methodology of the embolization of T2EL in the abdominal aorta with use of ethylene vinyl alcohol copolymer (EVOH). Complicating anatomic conditions are taken into account as well as technical and clinical success rates. Results Using the transarterial approach, there are at least 4 different pathways to access the nidus of a T2EL. CT-guided direct puncture of the aneurysm sac provides an alternative method of high technical success. EVOH with its slow solidification characteristics enables good control to achieve complete filling of the T2EL. During the intervention, however, it remains difficult to meet exactly the embolization endpoint, especially in large T2ELs. Conclusion T2EL embolization using EVOH is an effective treatment with low major complication rates when conducted by skilled interventionists with detailed knowledge of diverse complex access routes. Key Points: Citation Format

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“…The most established approaches can be broadly classified into transarterial and direct sac puncture techniques. [17][18][19] Newer, alternative approaches including transgraft 20 and perigraft 21 endoleak catheterizations have also been described. Determination of optimal approach is based on analysis of endoleak and feeder branch anatomy as well as available imaging equipment and provider experience.…”

Section: Embolization Strategiesmentioning

confidence: 99%

“…Another new approach to endoleak access is transarterial transgraft endoleak embolization, in which the endograft is purposely punctured to attain endoleak access. 20 Nakai et al described this approach in a patient with continued aneurysm sac enlargement after translumbar embolization of a type 2 endoleak-nBCA embolization was followed by graft reinforcement/relining, and resulted in resolution of endoleak, with aneurysm sac stability at 6-month follow-up. 30 Imaging Follow-up CTA and Doppler ultrasound are the most commonly used imaging modalities for follow-up after embolization of type 2 endoleaks.…”

Section: Transarterial Transgraftmentioning

confidence: 99%

Type 2 Endoleak Management

Chen¹,

Stavropoulos

2020

Semin intervent Radiol

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Type 2 endoleaks are the most common endoleak type following endovascular aneurysm repair. The natural history of these endoleaks can vary, with some demonstrating a self-limited or indolent course, while others can contribute to aneurysm sac enlargement and rupture. A variety of embolization techniques, including transarterial catheterization and direct sac puncture techniques, have been developed for the treatment of type 2 endoleaks. In this article, the authors review the indications, techniques, and outcomes of current treatment strategies for type 2 endoleaks.

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Laser-Assisted Transgraft Embolization: A Technique for the Treatment of Type II Endoleaks

Cited by 15 publications

References 14 publications

Transgraft embolization by using long needle for the treatment of type II endoleaks after endovascular abdominal aortic repair

Transgraft embolization by using long needle for the treatment of type II endoleaks after endovascular abdominal aortic repair

Embolization of Type 2 Endoleaks in the Abdominal Aorta Using Ethylene Vinyl Alcohol Copolymer

Type 2 Endoleak Management

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