Immediate and 1-year success rate of type 2 endoleak treatment using three-dimensional image fusion guidance - 21/08/20
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Highlights |
• | Trans-arterial embolization and direct percutaneous sac injection of type 2 endoleak using 3D-image fusion guidance have a technical success of 95%. |
• | Immediate and 1-year successful outcomes are reported in 94% and 88% of patients with type 2 endoleak after TAE with no major complications. |
• | Immediate and 1-year successful outcomes are reported in 100% and 89% of patients with type 2 endoleak after DPSI with no major complications. |
Abstract |
Purpose |
To retrospectively assess immediate and 1-year success rate of type 2 endoleak (T2E) treatment with ethylene-vinyl-alcohol-polymer using three-dimensional (3D) image fusion guidance with cone beam computed tomography via trans-arterial embolization (TAE) or direct percutaneous sac injection (DPSI).
Materials and methods |
A total of 37 patients with T2E who were treated either using TAE (34/37; 92%) or DPSI (9/37; 8%) were included. There were 34 men and 3 women with a mean age of 86±9 (SD) years (range: 67–104years). Mean aneurysm diameter was 67±14 (SD) mm (range: 42–101mm) at pre-procedure evaluation. Immediate success was complete embolization of the sac and feeding artery. 1-year success was reduction or stability of the aneurysmal sac diameter based on pre-procedure and 12-month follow-up examinations. Safety (treatment-related complications), patient demographics, duration of procedure and contrast volume were reported.
Results |
Immediate and 1-year successful outcomes were reported in 94% (n=32) and 88% (n=28) of patients after TAE and 100% (n=9) and 89% (n=8) after DPSI. T2E treatments were immediately successful for 95% of the procedures (41/43) and for 88% (36/41) at 1year. Overall, T2E treatment was effective in 33 patients (89%). No major complications occurred. Mean procedure time and contrast volume were significantly different between the 2 techniques with respectively 87±16 (SD) min (range: 65–120min) and 75±26 (SD) mL (range: 40–130mL) for TAE and 32±10 (SD) min (range: 20–50min) (P<0.01) and 6±6 (SD) mL (range: 2–22mL) (P<0.01) for DPSI. Mean aneurysm diameter at 1-year was 68±17 (SD) mm (range: 43–101mm). No significant differences in the pre-procedure sac diameter were found at long-term follow-up between patients without T2E and those with persistent T2E (P=0.1) in the successful embolization group (n=33).
Conclusion |
TAE or DPSI treatments of T2E with ethylene-vinyl-alcohol-polymer using 3D-image fusion guidance were immediately successful for 95% of the procedures and remained effective for 88%. Longer follow-up is necessary to assess sac stability in the case of persistent endoleak.
Le texte complet de cet article est disponible en PDF.Keywords : Endoleak, Endovascular aneurysm repair (EVAR), Ethylene-vinyl alcohol-polymer, Cone beam CT, Embolization
Plan
Vol 101 - N° 9
P. 589-598 - septembre 2020 Retour au numéro
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