Document Detail


Treatment of type II endoleak with a transcatheter transcaval approach: results at 1-year follow-up.
MedLine Citation:
PMID:  17543674     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study assessed the feasibility and mid-term outcomes in the treatment of type II endoleak using transcatheter transcaval embolization (TTE).
METHODS: During an 8-month period, 12 patients underwent TTE. After direct transcaval puncture of the aneurysm sac, embolization was performed by injecting thrombin and placing coils. Systemic and intrasac pressures were recorded throughout the entire procedure. Computed tomography (CT) scans were performed at 24 hours, 30 days, 6 months, and 1 year after TTE to evaluate endoleaks and changes in sac diameter. Technical success was defined as the feasibility of the procedure; clinical success was defined as no evidence of leaks during the follow-up evaluation.
RESULTS: TTE was feasible in 11 of 12 patients (technical success 92%). The mean systemic pressure was 117 mm Hg. The mean intrasac pressure before embolization was 75 mm Hg (range, 39 to 125 mm Hg), 16.5 mm Hg (range, 7 to 40 mm Hg) in 10 patients after embolization, and it increased in one patient. CT scans at 24 hours showed stable contrast medium inside the sac in 10 patients. Only minor complications were observed during follow-up. At the 1-year follow-up, no recurrence of leaks was noted, and sac diameter was reduced in 10 of 11 patients. As a result, TTE clinical success was obtained in 10 (83%) of 12 patients.
CONCLUSION: TTE appears to be a feasible technique for the complete exclusion of type II endoleaks. Technical and clinical successes are comparable with other treatment strategies, and TTE should be considered an alternative to direct translumbar puncture of the aneurysm sac.
Authors:
Giancarlo Mansueto; Daniela Cenzi; Alberto Scuro; Leonardo Gottin; Andrea Griso; Andrew A Gumbs; Roberto Pozzi Mucelli
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  45     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-04     Completed Date:  2007-07-13     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1120-7     Citation Subset:  IM    
Affiliation:
Department of Morphological and Biomedical Sciences-Radiology Institute, Intensive Care Unit, University Hospital GB Rossi, Verona, Italy. giancarlo.mansueto@univr.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angiography, Digital Subtraction
Aortic Aneurysm, Abdominal / physiopathology,  radiography,  surgery,  therapy*
Blood Pressure
Blood Vessel Prosthesis Implantation*
Embolization, Therapeutic / methods*
Feasibility Studies
Female
Follow-Up Studies
Humans
Male
Prospective Studies
Reoperation
Time Factors
Tomography, X-Ray Computed
Treatment Failure
Treatment Outcome
Vena Cava, Inferior* / radiography

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