Type 2 Endoleak Embolization Comparison: Translumbar Embolization versus Modified Transarterial Embolization

Purpose

To evaluate the success of endoleak repair using translumbar (TL) endoleak embolization compared with a transarterial (TA) technique that involves embolization of the endoleak cavity itself in addition to the feeding artery.

Materials and Methods

Eighty-four patients (mean age, 78.2 years; age range, 58–94 years) with type 2 endoleaks were included in this retrospective study. Patients underwent either TL endoleak embolization or TA embolization between January 2002 and December 2007. TA embolization involved entering the endoleak cavity through the inferior mesenteric or lumbar artery. Both the endoleak cavity and the feeding artery were then embolized by using coils through a microcatheter. TL embolizations were performed by using standard technique with coils and n-butyl cyanoacrylate as the embolization agents. Clinical success was defined as the absence of an endoleak and/or aneurysm enlargement at follow-up CT angiography. Statistical comparison was performed with the Fisher exact test.

Results

Endoleak repair was successful in 72% (45/62) of the TL embolizations and 78% (18/23) of the TA embolizations, with a mean follow-up of 18.7 months (range, 1–84 months). There was no significant difference in clinical success between the two groups (P = .41). There were two (3.2%) complications in the TL group and no complications in the TA group.

Conclusions

The effectiveness of the TA endoleak embolization technique, which involves embolizion of the endoleak cavity and the feeding artery, is similar to that of TL embolization for treatment of type 2 endoleaks.

Abbreviations: DSA, digital subtraction angiography, IMA, inferior mesenteric artery, TA, transarterial, TL, translumbar