Intraoperative evaluation for endoleaks using the SCORPION procedure during endovascular aortic repair

Area of Science:

• Vascular Surgery
• Medical Imaging
• Endovascular Interventions

Background:

• Endoleaks are common complications following endovascular aortic repair (EVAR).
• Current methods like aortography and CT scans provide indirect assessments of endoleaks, often with ambiguous findings.
• Direct visualization of endoleaks during surgery has been limited.

Purpose of the Study:

• To introduce and evaluate a novel intraoperative angioscopy procedure for direct endoleak detection.
• To assess the feasibility and safety of using angioscopy during EVAR for abdominal aortic aneurysms.
• To explore the potential of angioscopy in providing detailed hemodynamic information about endoleaks.

Main Methods:

• A prospective study involving consecutive patients undergoing EVAR for abdominal aortic aneurysms (excluding emergency cases and those with narrow access).
• Intraoperative angioscopy was performed using a novel endovascular technique to detect endoleaks.
• Data collected included patient demographics, aneurysm characteristics, and angioscopy findings.

Main Results:

• Seven patients successfully underwent EVAR with intraoperative angioscopy.
• No complications were reported in any of the enrolled patients.
• The angioscopy procedure successfully identified Type 2, 3a, and 4 endoleaks.

Conclusions:

• This study presents the first demonstration of intraoperative endoleak visualization using angioscopy.
• The direct visualization of endoleaks via angioscopy offers potential for assessing endoleak velocity and volume.
• This technique may provide comprehensive insights into intra-sac hemodynamics post-EVAR, improving patient management.