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. 2023 Apr 26;66(2):232-238.
doi: 10.33160/yam.2023.05.010. eCollection 2023 May.

Role of Aggressive Aneurysm Sac Embolization Before Endovascular Abdominal Aneurysm Repair in Preventing Type II Endoleak and Sac Expansion

Yasushi Yoshikawa  1 , Satoru Kishimoto  1 , Shohei Takasugi  2 , Yuichiro Kishimoto  1 , Takeshi Onohara  1 , Kunitaka Kumagai  1 , Rikuto Nii  1 , Nozomi Kishimoto  1 , Yuki Yoshikawa  1 , Shinsaku Yata  2 , Shinya Fujii  2 , Motonobu Nishimura  1
Affiliations

Role of Aggressive Aneurysm Sac Embolization Before Endovascular Abdominal Aneurysm Repair in Preventing Type II Endoleak and Sac Expansion

Yasushi Yoshikawa et al. Yonago Acta Med. .

Abstract

Background: This study aimed to evaluate the effect of aggressive embolization of side branches arising from the aneurysmal sac before endovascular aneurysm repair.

Methods: This retrospective study included 95 patients who underwent endovascular infrarenal abdominal aortic aneurysm repair at Tottori University Hospital between October 2016 and January 2021. Of these, 54 underwent standard endovascular aneurysm repair (conventional group), and 41 underwent coiling of the inferior mesenteric and lumbar arteries before undergoing endovascular aneurysm repair (embolization group). The occurrence of type II endoleak, change in aneurysmal sac diameter, and reintervention rate due to type II endoleak during follow-up were evaluated.

Results: Compared to the conventional group, the embolization group had a significantly lower incidence of type II endoleak, more frequent aneurysmal sac shrinkage, and lower aneurysmal sac growth related to type II endoleak.

Conclusion: Our results demonstrated the effectiveness of aggressive aneurysmal sac embolization before endovascular aneurysm repair to prevent type II endoleak and the consequent long-term aneurysmal sac enlargement.

Keywords: abdominal aortic aneurysm; endovascular aneurysm repair; type II endoleak.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1.
Fig. 1.
Representative CT angiogram prior and after EVAR with aggressive embolization. Left panel: representative preoperative CT angiogram. IMA and 4 LAs were arising from aneurysm. Right panel: postoperative CT angiogram of the same patient. Both IMA (shown with asterisk) and all LAs (shown with red arrows) were embolized with coils and endograft was placed in the aneurysm. IMA, inferior mesenteric artery; LA, lumbar artery.
See this image and copyright information in PMC

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