Anna Maria Ierardi1, Camilla Micieli1, Salvatore Alessio Angileri2, Nicola Rivolta3, Gabriele Piffaretti3, Massimo Tonolini4, Federico Fontana1, Vittorio Miele5, Luca Brunese6, Gianpaolo Carrafiello7. 1. Interventional Radiology, Department of Radiology, Insubria University, Viale Borri 57, 21100, Varese, VA, Italy. 2. Diagnostic and Interventional Radiology Unit, University of Milan, Viale di Rudinì 7, Milan, Italy. 3. Vascular Surgery Department, University of Insubria, Viale Borri 57, 21100, Varese, VA, Italy. 4. Department of Radiology, "Luigi Sacco" University Hospital, Via G.B. Grassi 74, 20157, Milan, MI, Italy. 5. Department of Emergency Radiology, S. Camillo Hospital, Circonvallazione Gianicolense 87, 00152, Rome, Italy. 6. Department of Radiology, Università degli Studi del Molise, Campobasso, CB, Italy. 7. Diagnostic and Interventional Radiology Unit, University of Milan, Viale di Rudinì 7, Milan, Italy. gcarraf@gmail.com.
Abstract
AIM: To evaluate safety, technical and clinical success of embolization of type II endoleak (T2 EL) using ethylene-vinyl alcohol copolymer as embolic agent alone or in combination with others materials. MATERIALS AND METHODS: From March 2007 to March 2015, 104 patients presented T2 EL during follow-up. A total of 21 patients met the criteria for treatment. T2 EL was treated with TAE (n = 18), DPSI (n = 10) or laparoscopic ligature of the inferior mesenteric artery (n = 1). DPSI was considered in case TAE was unsuccessful (8/18 patients). Ethylene-vinyl alcohol copolymer was used as embolic agent in 12 patients: alone in 5 cases, in association with glue and with glue and thrombin in 3 and 2 cases, respectively, during TAE. Onyx was injected in two cases of embolization performed with DPSI: in one case alone and in the other in combination with thrombin and glue. RESULTS: Technical success rate was 100%. Immediate clinical success was 91.7%; in one patient CEUS revealed persistent T2 EL, decreased if compared with that before the procedure. Secondary clinical success was 91.7%; until today, in one patient T2EL is persistent, nevertheless, the sac diameter remained stable. No major or minor complications were registered. CONCLUSIONS: Onyx could be an ideal embolic agent for endovascular and percutaneous embolization of T2 EL.
AIM: To evaluate safety, technical and clinical success of embolization of type II endoleak (T2 EL) using ethylene-vinyl alcohol copolymer as embolic agent alone or in combination with others materials. MATERIALS AND METHODS: From March 2007 to March 2015, 104 patients presented T2 EL during follow-up. A total of 21 patients met the criteria for treatment. T2 EL was treated with TAE (n = 18), DPSI (n = 10) or laparoscopic ligature of the inferior mesenteric artery (n = 1). DPSI was considered in case TAE was unsuccessful (8/18 patients). Ethylene-vinyl alcohol copolymer was used as embolic agent in 12 patients: alone in 5 cases, in association with glue and with glue and thrombin in 3 and 2 cases, respectively, during TAE. Onyx was injected in two cases of embolization performed with DPSI: in one case alone and in the other in combination with thrombin and glue. RESULTS: Technical success rate was 100%. Immediate clinical success was 91.7%; in one patient CEUS revealed persistent T2 EL, decreased if compared with that before the procedure. Secondary clinical success was 91.7%; until today, in one patient T2EL is persistent, nevertheless, the sac diameter remained stable. No major or minor complications were registered. CONCLUSIONS: Onyx could be an ideal embolic agent for endovascular and percutaneous embolization of T2 EL.
Entities:
Keywords:
Embolization; Ethylene-vinyl alcohol copolymer; Onyx; Type II endoleak
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