Thoracic endoleak embolization using a direct percutaneous puncture of the endoleak through lung parenchyma.

An 84-year-old patient presented with an endoleak after endovascular repair of a ruptured thoracic aortic aneurysm. The endoleak was thought to be a type II endoleak on computed tomographic (CT) angiography and was not visualized on angiography. The endoleak was accessed via direct puncture of the endoleak sac through the pleura and lung parenchyma with use of fluoroscopic and C-arm CT guidance. The endoleak was embolized with platinum coils and n-butyl cyanoacrylate with no complications. Follow-up imaging with CT angiography at 43 days revealed no recurrent endoleak.