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Related Experiment Video

Updated: Nov 10, 2025

Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
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Tailored Sac Embolization During EVAR for Preventing Persistent Type II Endoleak.

Chiara Mascoli1, Gianluca Faggioli1, Enrico Gallitto1

  • 1Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.

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|April 6, 2021
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Summary

Persistent type II endoleaks after EVAR can be reduced by optimizing coil embolization. Higher coil concentration (≥0.17 coils/cm³) and lower endoluminal residual volume (ERV < 49 cm³) are key factors in preventing these leaks.

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Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Medical Device Technology

Background:

  • Persistent type II endoleaks (ELIIp) complicate 8-23% of endovascular aneurysm repair (EVAR) procedures.
  • ELIIp can lead to abdominal aortic aneurysm (AAA) progression and rupture.
  • Intraoperative AAA sac embolization is effective, but standardization is lacking.

Purpose of the Study:

  • To identify factors predicting ELIIp prevention after intraoperative AAA sac embolization.
  • To optimize technical details of embolization procedures.
  • To reduce the incidence of ELIIp post-EVAR.

Main Methods:

  • Prospective collection of high-risk EVAR patients undergoing AAA sac coil embolization.
  • Calculation of endoluminal residual sac volume (ERV) and coil concentration (CCoil).
  • Comparison of patients with (Group 1) and without (Group 2) ELIIp at 12 months.

Main Results:

  • Among 61 high-risk patients, 23% developed ELIIp at 12 months.
  • Group 1 (ELIIp) had significantly higher ERV (59 cm³ vs. 42 cm³) and lower CCoil (0.09 vs. 0.18 coils/cm³).
  • ELIIp was associated with ERV > 49 cm³ and CCoil < 0.17 coils/cm³.

Conclusions:

  • Coil concentration and ERV impact AAA sac embolization efficacy for ELIIp prevention.
  • A CCoil of ≥0.17 coils/cm³ may guide tailored coil எண்ணிக்க.
  • Optimizing embolization technique is crucial for preventing ELIIp.