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Interact CardioVasc Thorac Surg 2008;7:781-784. doi:10.1510/icvts.2008.178624
© 2008 European Association of Cardio-Thoracic Surgery
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Institutional report - Aortic and aneurysmal

Translumbar treatment of type II endoleaks after endovascular repair of abdominal aortic aneurysm

Michael Gorlitzera,*, Gerard Mertikianb, Hubert Trnkab, Alexander Froeschla, Johann Meinhartc, Gabriel Weissa, Martin Grabenwoegera and Thomas Randb

a Department of Cardiovascular Surgery, Hospital Hietzing, Wolkersbergenstr. 1, A-1130 Vienna, Austria
b Department of Radiology, Hospital Hietzing, Vienna, Austria
c Karl Landsteiner Institute for Cardiovascular Research, Hospital Hietzing, Vienna, Austria

*Corresponding author. Tel.: +43-1-80110; fax: +43-1-80110-2729.

E-mail address: michael.gorlitzer{at}wienkav.at (M. Gorlitzer).

The modality of treatment and the appropriate time point to treat type II endoleaks after endovascular repair of abdominal aortic aneurysms (EVAR) remain controversial issues. The purpose of the present study was to assess the efficacy of translumbar embolization of type II endoleaks after endovascular repair of aortic aneurysm repair. Eighty-four consecutive patients after EVAR were analyzed for the onset of type II endoleaks. Of these, five patients had experienced translumbar embolization after ineffective intraartrial approach to exclude the endoleak. A combination of several liquid embolic agents was used as sealant. Post-procedural contrast-enhanced ultrasound (CEUS) was used to document the outcome of the embolization. Translumbar embolization was successful in four patients. Complete sealing of the nidus was seen on CEUS 24 h after the procedure. In one patient with a duplication of the inferior vena cava, the procedure was aborted because an additional type Ib endoleak was found. The procedure was well tolerated by all patients. The translumbar approach to treat growing aneurysm sacs in patients with persistent type II endoleaks is safe and well tolerated. The immediate post-interventional outcome as documented on CEUS is promising. Long-term follow-ups are yet to be performed.

Key Words: Endovascular; Aortic aneurysm; Endoleak; Embolization

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