Type 2 endoleak embolization comparison: translumbar embolization versus modified transarterial embolization.

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Endovascular Aneurysm Repair

Background:

• Type 2 endoleaks are a common complication following endovascular aneurysm repair.
• Effective treatment is crucial to prevent aneurysm expansion and rupture.
• Translumbar (TL) and transarterial (TA) embolization are established techniques for managing type 2 endoleaks.

Purpose of the Study:

• To compare the clinical success and complication rates of translumbar (TL) endoleak embolization versus transarterial (TA) embolization for type 2 endoleaks.
• To evaluate the effectiveness of TA embolization, which targets both the endoleak cavity and feeding artery.

Main Methods:

• Retrospective study of 84 patients with type 2 endoleaks.
• Patients underwent either TL embolization (coils and n-butyl cyanoacrylate) or TA embolization (coils targeting cavity and feeding artery).
• Clinical success defined as absence of endoleak or aneurysm enlargement on CT angiography.

Main Results:

• Clinical success rates were 72% for TL embolization (45/62) and 78% for TA embolization (18/23).
• No significant difference in clinical success between the two groups (P = .41).
• Two complications (3.2%) occurred in the TL group; none in the TA group.

Conclusions:

• Transarterial (TA) embolization is as effective as translumbar (TL) embolization for treating type 2 endoleaks.
• TA embolization, involving embolization of both the endoleak cavity and feeding artery, offers a safe alternative with comparable outcomes.