Roberto Gandini MD, Abstract Co-Author: Nothing to Disclose

Daniel Konda, Presenter: Nothing to Disclose

Luca Boi MD, Abstract Co-Author: Nothing to Disclose

Livio Di Vito MD, Abstract Co-Author: Nothing to Disclose

Marcello Chiocchi MD, Abstract Co-Author: Nothing to Disclose

Costantino Del Giudice MD, Abstract Co-Author: Nothing to Disclose

Giovanni Simonetti MD, Abstract Co-Author: Nothing to Disclose

To investigate the feasibility and efficacy of trans-caval endoleak embolization (TCEE) of type I and II endoleaks occurring after endovascular abdominal aortic aneurysm repair (EVAR).

Fourteen patients (6 men, 8 women; mean age 71.6 ± 7.9, range 69-85) with type Ia, II and Ia-II endoleaks and aneurysm sac growth following EVAR were treated by TCEE. In all patients the aneurysm sac was adherent to the inferior vena cava. Type I endoleaks were embolised using coils while type II endoleaks were embolised with a combination of coils, Glubran 2 acrylic glue and thrombin. Follow-up was performed by Computed Tomography angiography (CTA) at 1, 6, 12 and 18 months after the procedure. The institutional review board at our institution gave full approval and waiver of informed consent for our retrospective study and had previously approved our treatment protocol. Written patient informed consent was obtained from each patient prior to treatment.

TCEE was technically successful in all patients (100%). Intrasac pressure dropped from a mean of 63.6 ± 15.2 mmHg (range: 43-89) to a mean of 7.8 ± 2.3 mmHg (range: 5-12). Mean time of fluoroscopy was 15.4 ± 4.1 minutes (range: 10-22). During a mean 9.9 ± 4.5 month (range: 6-18) follow-up period, no aneurysm-related deaths, further increases in aneurysm sac diameter or endoleak recurrences were observed.

TCEE of type I and II endoleaks associated with aneurysm sac enlargement is a safe, effective and feasible procedure. This technique does not require high operational skills and can be performed by all endovascular specialists without the need of CT guidance.

TCEE is a feasible procedure that can be performed by all endovascular specialists under fluoroscopic guidance without the need of a CT apparatus.

Gandini, R, Konda, D, Boi, L, Di Vito, L, Chiocchi, M, Del Giudice, C, Simonetti, G, Trans-caval Endoleak Embolization (TCEE) of Type I and II Endoleaks Occurring after Endovascular Abdominal Aortic Aneurysm Repair (EVAR).  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9013654.html