Transcaval embolisation of type-II endoleaks - The Australian experience.
Kevin Tian1,2, Vimalin Samuel1, David Sun1
1Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, QLD, Australia.
Vascular
|January 6, 2025
Summary
Transcaval embolization effectively treats type-II endoleaks in abdominal aortic aneurysms, showing high success rates and potential for sac regression. This minimally invasive approach offers a promising solution for endograft complications.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Endovascular Aneurysm Repair
Background:
- Type-II endoleaks are a common complication after abdominal aortic aneurysm (AAA) endografting.
- Persistent endoleaks can lead to AAA sac enlargement and rupture.
- Transcaval embolization is an emerging technique to address these endoleaks.
Purpose of the Study:
- To evaluate the technical and clinical outcomes of transcaval embolization for type-II endoleaks.
- To assess the impact of this procedure on AAA sac size and patient mortality.
Main Methods:
- Retrospective cohort study of 12 patients undergoing transcaval embolization for type-II endoleak over 9 years.
- Primary outcome: clinical success (absence of endoleak at 6 weeks).
- Secondary outcomes: 1-year clinical success, aneurysm sac size changes, rupture, and mortality.
Main Results:
- Technical success rate of 91.7% with embolization using Onyx and coils.
- Clinical success at 6 weeks was 66.7%, with no endoleaks at 1 year.
- Clinically successful cases showed decreased sac size; unsuccessful cases showed enlargement.
- No AAA rupture or aneurysm-related mortality observed.
Conclusions:
- Transcaval embolization demonstrates high technical and clinical success for type-II endoleaks.
- The procedure may induce abdominal aortic aneurysm sac regression.
- This technique represents a viable option for managing endoleak complications.
