Assaf Graif MD, Presenter: Nothing to Disclose

Mark Joseph Garcia MD, Abstract Co-Author: Nothing to Disclose

Christopher Joseph Grilli DO, Abstract Co-Author: Nothing to Disclose

Clinton W. Wrigley MD, Abstract Co-Author: Nothing to Disclose

Daniel Andreas Leung MD, Abstract Co-Author: Nothing to Disclose

1. To review the pathophysiology and prognosis of endoleaks after AAA repair. 2. Discuss the benefits of Onyx (EV3 Inc., Plymouth, MN) as a liquid embolic agent, as compared to coils. 3. Pictorial description of the different approaches to endoleak repair using Onyx, while focusing on type II endoleaks.

A. Short review of the 5 types of endoleaks. B. Focused review of the pathophysiology, prevalence, complications and prognosis of untreated type II endoleaks. C. Current indications for treatment of endoleaks. a. Follow-up protocols: CT and/or ultrasound b. Size criteria D. Short description of Onyx and its properties. E. Describing the different techniques of accessing the aneurysmal sac, when using onyx: a. Endovascular: i. Accessing the inferior mesenteric artery through the marginal artery of Drummond. ii. Catheterizing lumbar arteries via the internal iliac and iliolumbar arteries. b. Direct sac access: i. CT or fluoroscopic guided translumbar ii. Ultrasound guided transabdominal c. Combined endovascular/direct approach; a novel method of accessing the aneurysm sac by perigraft catheterization between the endograft and the vascular wall at an anastomotic site. F. Comparing and contrasting the different repair techniques in regards to indications, efficacy, and complications.  

http://abstract.rsna.org/uploads/2014/14018588/14018588_pd68.pdf

Graif, A, Garcia, M, Grilli, C, Wrigley, C, Leung, D, Novel Techniques for Catheterizing the Excluded Aneurysm Sac for the Purpose of Embolization of Endoleaks Associated with Endovascular Repair of AAAs.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018588.html