TY - JOUR
T1 - Step-by-Step Approach to Management of Type II Endoleaks
AU - Bryce, Yolanda
AU - Lam, Cuong (Ken)
AU - Ganguli, Suvranu
AU - Schiro, Brian J.
AU - Cooper, Kyle
AU - Cline, Michael
AU - Oklu, Rahmi
AU - Vatakencherry, Geogy
AU - Peña, Constantino S.
AU - Gandhi, Ripal T.
N1 - Publisher Copyright:
© 2018
PY - 2018/9
Y1 - 2018/9
N2 - Seventy-five percent of abdominal aortic aneurysms are now treated by endovascular aneurysm repair (EVAR) rather than open repair, given the decreased periprocedural mortality, complications, and length of hospital stay for EVAR compared to the surgical counterpart. An endoleak is a potential complication after EVAR, characterized by continued perfusion of the aneurysm sac after stent graft placement. Type II endoleak is the most common endoleak, and often has a benign course with spontaneous resolution, occurring in the first 6 months after repair. However, these type II endoleaks may result in pressurization of the aneurysm sac and potentially sac rupture. They occur from retrograde collateral blood flow into the aneurysm sac, typically from a lumbar artery or the inferior mesenteric artery. Alternative sources include accessory renal, gonadal, median sacral arteries, and the internal iliac artery. We will discuss our protocol for post-EVAR imaging surveillance and potential type II endoleak treatment strategies, including transarterial, translumbar, transcaval, and perigraft approaches, as well as open surgery.
AB - Seventy-five percent of abdominal aortic aneurysms are now treated by endovascular aneurysm repair (EVAR) rather than open repair, given the decreased periprocedural mortality, complications, and length of hospital stay for EVAR compared to the surgical counterpart. An endoleak is a potential complication after EVAR, characterized by continued perfusion of the aneurysm sac after stent graft placement. Type II endoleak is the most common endoleak, and often has a benign course with spontaneous resolution, occurring in the first 6 months after repair. However, these type II endoleaks may result in pressurization of the aneurysm sac and potentially sac rupture. They occur from retrograde collateral blood flow into the aneurysm sac, typically from a lumbar artery or the inferior mesenteric artery. Alternative sources include accessory renal, gonadal, median sacral arteries, and the internal iliac artery. We will discuss our protocol for post-EVAR imaging surveillance and potential type II endoleak treatment strategies, including transarterial, translumbar, transcaval, and perigraft approaches, as well as open surgery.
KW - endoleak
KW - endovascular aneurysm repair
KW - translumbar embolization
KW - type II endoleak
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U2 - 10.1053/j.tvir.2018.06.009
DO - 10.1053/j.tvir.2018.06.009
M3 - Article
C2 - 30497554
AN - SCOPUS:85049299046
SN - 1089-2516
VL - 21
SP - 188
EP - 195
JO - Techniques in Vascular and Interventional Radiology
JF - Techniques in Vascular and Interventional Radiology
IS - 3
ER -