CT- and Fluoroscopy-Guided Percutaneous Transabdominal Embolization of Type II Endoleak

We report a case of a 79-year-old male patient who was treated 3 years previously at another hospital for an abdominal aortic aneurysm with a maximal diameter of 80 mm. After the treatment control period, computed tomography imaging revealed a type II endoleak and no progression in the size of the aneurysm sac. Selective injection of the superior mesenteric artery revealed that the endoleak was filled by the inferior mesenteric artery via the marginal artery. However, it was not possible to access using retrograde catheterization. We decided to treat the type II endoleak percutaneously. Embolization was performed at the tomography table using fluoroscopy with a mobile C-arm, and the puncture was performed transabdominally because there was no access to the sac via a translumbar approach. Under fluoroscopic guidance, various diameter/length coils were deployed. Follow-up computed tomography scans confirmed the collapsed aneurysm sac. When other conventional endovascular methods have failed, percutaneous transabdominal treatment of a type II endoleak with sac enlargement offers an alternative treatment method.