Safety and Efficacy of Embolization Using N-Butyl Cyanoacrylate via a Percutaneous Direct Approach for Endoleaks after Abdominal/Thoracic Endovascular Aortic Repair

• Ushijima Yasuhiro

  Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University

• Asayama Yoshiki

  Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University

• Nishie Akihiro

  Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University

• Ishigami Kousei

  Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University

• Takayama Yukihisa

  Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University

• Okamoto Daisuke

  Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University

• Fujita Nobuhiro

  Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University

• Morita Koichiro

  Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University

• Honda Hiroshi

  Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University

Abstract

Purpose: To elucidate the safety and efficacy of embolization using N-butyl cyanoacrylate (NBCA) for endoleaks after abdominal/thoracic endovascular aortic repair (EVAR/TEVAR) via a direct percutaneous approach versus a transarterial approach. Materials and Methods: The retrospective design of the study was approved by the institutional ethics committee, and the requirement for informed written consent was waived. Sixteen patients underwent embolization for endoleaks after EVAR/TEVAR, which was diagnosed as type II, from March 2010 to December 2013 at our institution. The number of embolization sessions was 21. A direct percutaneous approach was used in 10 sessions, and a transarterial approach was used in 11 sessions. There were 11 and 15 embolic sites for the two approaches, respectively. The procedure time, amount of contrast media used, therapeutic effect, and complications were evaluated. Results: The mean procedure time (per embolic site) was 100 min (53-170) in the direct percutaneous approach, which was significantly shorter than the 191 min (76-275) in the transarterial approach. The mean amount of contrast media used during the procedure (per embolic site) was 12.8 ml (3-25) by the direct percutaneous approach, which was significantly lesser than the 71.8 ml (30-180) in the transarterial approach. Local control of the embolic site and interval increase in the size of aneurysm after embolization were not significantly different between the two approaches. In one case each, mesenteric hematoma and migration of the embolic agent occurred with a direct percutaneous approach, and a small arterial injury occurred with the transarterial approach; aneurysmal rupture/perianeurysmal hematoma and neurological dysfunction were not observed. Conclusion: A direct percutaneous approach is a feasible procedure for embolization of endoleaks after EVAR/TEVAR.

Journal

• Interventional Radiology

  Interventional Radiology 5 (1), 1-9, 2020-02-28

  Japanese Society of Interventional Radiology

Keywords

• EVAR
• TEVAR
• endoleak
• embolization
• NBCA
• percutaneous direct approach

Details

• CRID: 1390283659855034368
• NII Article ID: 130007803376
• DOI: 10.22575/interventionalradiology.2018-0018
• ISSN: 24320935
• Web Site: https://www.jstage.jst.go.jp/article/interventionalradiology/5/1/5_2018-0018/_pdf
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed