Midterm results of periprosthetic coiling embolization in high-risk patients

With increasing interest in the prevention of type II endoleaks (EII), the aim of this study was to report midterm results on the intraoperative coiling embolization of the periprosthetic aneurysmal sac in patients at high-risk of EII.

A retrospective review study was conducted with 124 patients with infrarenal abdominal aortic aneurysm who accorded with the inclusion criteria, including 66 patients who underwent standard endovascular aortic aneurysm repair (Group A) and 58 patients who underwent aneurysmal sac coiling embolization (Group B). Baseline data and follow-up results were analyzed.

A mean of 2.84 ± 1.45 coils (range 1-9) were used in Group B. The general incidence of an EII was 15.32% (19/124) at a mean follow-up time of 46.60 ± 15.14 months, with 22.7% (15/66) in Group A and 6.9% (4/58) in Group B (χ² = 5.62; P = 0.018). Logistic multivariate analysis revealed that the independent risk factors of an EII were no sac embolization and a sac volume ≥128 cm³. The Kaplan-Meier subgroup analysis showed no difference in regard to the rate of freedom from EII between the two groups either with a larger or smaller sac.

These results suggest that periprosthetic coiling embolization in patients at high-risk of EII is safe and effective in the prevention of EII. The preventive effect seemed to be weakened when the sac volumes were taken into consideration at midterm follow-up.