Effectiveness Evaluation of Preventive Embolization of the Internal Iliac Artery in Preventing Type II Endoleaks

Purpose  The aim of this study was to evaluate the effectiveness of the proposed method of preventive embolization of the internal iliac arteries using a liquid tantalum-containing ethylene vinyl alcohol copolymer. Methods  In this nonrandomized clinical study with a retrospective control group, 55 patients with aneurysmal lesions of the infrarenal abdominal aorta participated. In the course of this study, we developed and implemented a method of preventive embolization of the ostia of the internal iliac artery using a liquid tantalum containing ethylene-vinyl alcohol copolymer having viscosity of 34 centipoise. The method was applied in 27 cases in patients with aneurysmal lesions of the infrarenal abdominal aorta with unilateral involvement of the common iliac artery. The maximum follow-up period at the stage of publication of the results was 24 months. Results  The proposed method of embolization of the internal iliac artery is accompanied by an absolute risk of developing type II endoleak 0.393 (95% confidence interval: 0.2120-0.5738, p  = 0.029); therefore, when using the new technique, there is a decrease in the absolute risk of developing type II endoleak by 39.3%. Conclusion  The proposed method of preventive embolization allows to perform reliable occlusion of the internal iliac artery as proximally as possible, which makes it possible to maintain distal blood flow in the internal iliac artery and minimizes the risks of ischemic events.