Coil embolization of intercostal arteries accessed by surgical exposure for type II endoleak after thoracic endovascular aortic repair.

Many patients with type II endoleak after thoracic endovascular aortic repair (TEVAR) are closely observed without secondary intervention. Herein, we report a new technique of coil embolization for type II endoleak from intercostal arteries after TEVAR for ruptured acute type B aortic dissection. A hybrid procedure of exposing intercostal arteries via subcostal incision in the prone position and transcatheter technique enables embolization of intercostal arteries at their origin from the aorta. This technique could avoid lung injury and be applicable in multiple intercostal arteries. This technique may be a useful secondary intervention for type II endoleak after TEVAR caused by intercostal arteries.