Comparison of Type II Endoleak Treatment: Direct sac Puncture versus Transarterial Embolization, a Retrospective Cohort Analysis

Sunday, March 5, 2023

3:00 PM – 3:09 PM

Location: Phoenix Convention Center, 222C

Presenting Author(s)

AM

Arash Mirrahimi, MD, MSc, HBSc

Clinical Fellow
McMaster University

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

SS

Steffan Stella, MD, PhD

Staff Interventional Radiologist
McMaster University
Rd

Russell de Souza, ScD, RD

Associate Professor
McMaster University
SN

Sabarinath Nair, MBBS

Associate Professor
McMaster University
GM

George Markose, MBBS

Associate Professor
McMaster University
GY

Gordon Yip, MD

Assistant Clinical Professor
McMaster University
FG

Fernando Gastaldo, MD

Associate Professor
Hamilton General Hospital

Disclosure(s):

Arash Mirrahimi, MD, MSc, HBSc: No financial relationships to disclose

Purpose: Type II endoleak remains one of the most common complications after endovascular aneurysm repair. The current study compares outcomes of type II endoleak embolization using direct sac puncture approach versus transarterial embolization in patients treated with endovascular repair of aortic aneurysms in a single centre retrospective cohort.

Materials and Methods:

This a retrospective observational cohort of patients who underwent percutaneous treatment of type II endoleak from 2008 to 2017. Patients were divided into 2 groups: embolization of endoleak via transarterial approach (group A) and embolization of endoleak via direct puncture of the sac (group B). Outcomes were compared between groups by the Pearson χ2 tests.

Results:

A total of 87 consecutive patients (mean age, 77.4 y; range, 61–93 y) were included in the study, 85% were men and 15% were women. Mean interval from endovascular aneurysm repair to embolization was 20.7 months ± 15.8 with a median of 17 months (range 0-79 months). Median follow up was 47 months (range 2-105 months). There was a significant difference between clinical success, determined by sac decrease/stabilization on follow-up CT, of direct sac puncture vs. transarterial embolization (77% vs 46%; P = .011).

Conclusion:

There was significantly higher clinical success with embolization of type II endoleak via a direct sac puncture compared to transarterial embolization in our retrospective cohort on first attempt intervention.