Effective treatment of type IIb endoleak via targeted translumbar embolization

After endovascular aneurysm repair, type II endoleaks are encountered frequently, and warrant intervention when associated with aneurysmal sac expansion. Thus, the contemporary vascular surgeon must be able to manage them. The presented case illustrates our approach to percutaneous translumbar selective coil embolization of individual lumbar arteries feeding the type IIb endoleak. The use of specific imaging systems allows for needle track guidance to access the endoleak pocket. Treatment of the feeding vessels with detachable coils can be achieved with a direct route via the translumbar sheath. The benefits of this approach include avoidance of graft puncture, targeted therapy, and low puncture-related complications.