Arc of Riolan to the rescue: transcollateral endoleak embolization

Area of Science:

• Vascular Surgery
• Interventional Radiology

Background:

• Endovascular aneurysm repair (EVAR) is a common treatment for abdominal aortic aneurysms.
• Type II endoleaks can persist after EVAR, potentially leading to aneurysm sac enlargement.
• Management of persistent type II endoleak requires precise identification of the feeding vessel.

Purpose of the Study:

• To describe a case of persistent type II endoleak following EVAR.
• To illustrate the utility of CT angiography in identifying endoleak pathways.
• To demonstrate successful endovascular embolization for persistent type II endoleak.

Main Methods:

• A patient with persistent type II endoleak post-EVAR was evaluated.
• Computed tomography (CT) angiography was performed to delineate the endoleak source and vascular anatomy.
• Endovascular embolization was performed to occlude the identified feeding vessel.

Main Results:

• CT angiography accurately identified the vascular pathway of the persistent type II endoleak.
• Endovascular embolization successfully occluded the endoleak.
• The endoleak was resolved post-embolization.

Conclusions:

• CT angiography is crucial for diagnosing and planning treatment for persistent type II endoleak.
• Endovascular embolization is an effective treatment for persistent type II endoleak.
• This case highlights a successful minimally invasive approach to managing EVAR complications.