Transcatheter Embolization of a Type II Endoleak after Hybrid Repair for Thoracoabdominal Aortic Aneurysm

Percutaneous embolization of patent intercostal artery causing persistent type II endoleak and sac enlargement of thoracoabdominal aneurysm 2 years after hybrid repair

“…The endoleak was successfully treated by transcatheter coil embolization. 11 In our case, we confirmed the absence of type I or III endoleaks by performing digital subtraction angiography a few days before direct sac puncture. We used the combination of fluoroscopic and DynaCT guidance to treat the type II endoleak, which was located in the proximal third of the sac along the inner curve of the aortic arch.…”

“…In addition, we selectively embolized the feeding intercostal artery in addition to the endoleak nidus. Heye and associates 11 reported on a patient with type II endoleak 2 weeks after a hybrid thoracoabdominal aortic aneurysm repair. The endoleak was originating from a celiac artery that had not been ligated at its origin.…”

Transcatheter arterial embolization of a type 2 endoleak through the dorsal pancreatic artery after the hybrid repair of a thoracoabdominal aortic aneurysm: A case report

“…T2EL can occur after hybrid TAAA repair caused by retrograde flow through the intercostal, celiac, splenic, and aberrant left gastric arteries [ 5 , 7 ]. In previous studies, T2EL from the celiac artery occurred when the celiac artery was not ligated or ligated distally [ 4 , 7 ]. In this case, the celiac artery branches were embolized during TEVAR, but an endoleak occurred through an unembolized DPA after hybrid repair.…”

“…Hybrid repair is an alternative approach involving open extra-anatomic bypass and endovascular exclusion of the aneurysm [3] . Only a few reports have described the percutaneous treatment of a type 2 endoleak (T2EL) after hybrid repair [4] , [5] , [6] . Therefore, this report adds to the literature by describing our experience with a T2EL after hybrid TAAA repair.…”

Clinical significance of type II endoleaks after thoracic endovascular aortic repair

“…ELII via the celiac axis or intercostal arteries is favorably approached by EL embolization by coils and/or liquid embolic agents (ie, n-butyl cyanoacrylate or ethylene vinyl alcohol). [27][28][29] The procedure can be performed percutaneously through a transarterial or translumbar/transthoracic approach. In our series, a 67-year-old female with an ELII via an intercostal artery after hybrid TAAA repair was interventionally treated by CT-guided punction of the aneurysm sac and subsequent application of multiple coils (patient no.…”