Document Detail


Evaluation and treatment of suspected type II endoleaks in patients with enlarging abdominal aortic aneurysms.
MedLine Citation:
PMID:  22609291     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate angiographic diagnosis and embolotherapy of patients with enlarging abdominal aortic aneurysms and computed tomographic (CT) diagnosis of type II endoleak.
MATERIALS AND METHODS: A retrospective review was performed of all patients referred to a single vascular and interventional radiology section from January 1, 2003, to June 1, 2011, with a diagnosis of enlarging aneurysm and type II endoleak. Twenty-five patients underwent 40 procedures between 12 and 82 months after endograft insertion (mean, 48 mo) for diagnosis and/or treatment of endoleaks.
RESULTS: Type II endoleaks were treated with cyanoacrylate, coils, and ethylene vinyl alcohol copolymer in 16 patients. Technical success rate was 88% (14 of 16 patients) and clinical success rate was 100% (16 of 16 patients). Aneurysm growth was arrested in all cases over a mean follow-up of 27.5 months (range, 6-88 mo). Endoleaks in nine patients were misclassified on CT; two had type I endoleaks and seven had type III endoleaks. Four of the nine patients (two type I endoleaks and two type III endoleaks) were correctly classified after initial angiography. The other five type III endoleaks were correctly classified on CT after coil embolization of the inferior mesenteric artery. Direct embolization was performed via sac puncture with ethylene vinyl alcohol copolymer in two of the latter five patients and eliminated endoleaks in both.
CONCLUSIONS: Aneurysm growth caused by type II endoleaks was arrested by embolization. CT misclassification occurred relatively commonly; type III endoleaks purported to be type II endoleaks were found in 28% of patients (seven of 25).
Authors:
Brian Funaki; Nour Birouti; Steven M Zangan; Thuong G Van Ha; Jonathan M Lorenz; Rakesh Navuluri; Christopher L Skelly; Jeffrey A Leef
Publication Detail:
Type:  Journal Article     Date:  2012-05-19
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  23     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-22     Completed Date:  2012-11-16     Revised Date:  2013-06-24    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  866-72; quiz 872     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.
Affiliation:
Section of Vascular and Interventional Radiology, Department of Radiology, University of Chicago Medical Center, 5840 S. Maryland Ave., MC 2026, Chicago, IL 60637, USA. bfunaki@radiology.bsd.uchicago.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal / complications,  radiography*,  therapy*
Embolization, Therapeutic / methods*
Endoleak / etiology,  radiography*,  therapy*
Female
Hemostatics / therapeutic use*
Humans
Male
Middle Aged
Radiography, Interventional / methods*
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Treatment Outcome
Grant Support
ID/Acronym/Agency:
K08 HL091053/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Hemostatics
Comments/Corrections

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