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04.06.2016 | Original Article

A multi-institutional survey of interventional radiology for type II endoleaks after endovascular aortic repair: questionnaire results from the Japanese Society of Endoluminal Metallic Stents and Grafts in Japan

verfasst von: Yukihisa Ogawa, Hiroshi Nishimaki, Keigo Osuga, Osamu Ikeda, Norio Hongo, Shinichi Iwakoshi, Ryota Kawasaki, Reiko Woodhams, Masato Yamaguchi, Mika Kamiya, Masayuki Kanematsu, Masanori Honda, Toshio Kaminou, Jun Koizumi, Kimihiko Kichikawa

Erschienen in: Japanese Journal of Radiology | Ausgabe 8/2016

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Abstract

Purpose

To investigate the current status of interventional radiology (IR) procedures for a type II endoleak (T2EL) in Japan, and to identify the technical aspects that affect treatment results.

Materials and methods

A retrospective survey was conducted by distributing questionnaires to 25 institutions. The eligibility criteria were endovascular aortic repair (EVAR) performed using commercial stent grafts and IR performed for T2EL between January 2007 and December 2013. Technical success was defined as disappearance of the EL on digital subtraction angiography immediately after embolization, and imaging success was defined as no EL on contrast-enhanced computed tomography within 6 months. Statistical comparisons of the number of involved branches, embolization level, embolic material, and changes in aneurysm size were made between the imaging success and imaging failure groups. The technical and imaging success rates were also compared between the initial therapy and repeat groups.

Results

A total of 166 cases were investigated. Initial therapy was performed in 147 cases (88.6 %), with repeat therapy in 19 cases (11.4 %). Transcatheter arterial embolization (TAE) was used most frequently, in 161 cases (97 %), with direct puncture (DP) used in 5 cases (3 %). Both coil embolization for the branches and NBCA embolization for the sac were frequently chosen. The technical success rate was 83.2 % (TAE group), and the imaging success rate was 46.5 % (TAE + DP groups). Branch + sac embolization was performed more frequently in the imaging success group. There was no significant difference in the number of involved branches or embolic material between the imaging success and imaging failure groups. Enlargement of the aneurysm was more frequently seen in the imaging failure group. There were no significant differences in the technical success and imaging success rates between the initial therapy and repeat groups.

Conclusion

This is the first report of a multi-institutional questionnaire survey of IR procedures for T2EL after EVAR in Japan that was conducted to determine the current status. Enlargement of aneurysm size after embolization was more frequently seen in the imaging failure group. It is important to embolize both branch and sac to achieve imaging success, regardless of embolic material. Long-term outcomes need to be investigated.

Mehta M, Sternbach Y, Taggert JB, Kreienberg PB, Robby SP, Paty PSK, et al. Long-term outcomes of secondary procedures after endovascular aneurysm repair. J Vasc Surg. 2010;52:1442–8.CrossRefPubMed

Jones JE, Atkins MD, Brewster DC, Chung TK, Kwolek CJ, LaMuraglia GM, et al. Persistent type 2 endoleak after endovascular repair of abdominal aortic aneurysm is associated with adverse late outcomes. J Vasc Surg. 2007;46:1–8.CrossRefPubMed

van Marrewijk CJ, Fransen G, Raheij RJ, Harris PL, Buth J, EUROSTAR Collaborators. Is a type II endoleak after EVAR a harbinger risk? Causes and outcome of open conversion and aneurysm rupture during follow up. Eur J Endovasc Surg. 2004;27:128–37.

Sidroff DA, Stather PW, Choke E, Bown MJ, Sayers RD. Type II endoleak after endovascular aneurysm repair. Br J Surg. 2013;100:1262–70.CrossRef

Fransen GA, Vallabhaneri SR Sr, van Marrewijk CJ, Raheij RJ, Harris PL, Buth J, et al. Rupture of infra-renal aortic aneurysm after endovascular repair: a series from EUROSTAR registry. Eur J Endovasc Surg. 2003;26:487–93.CrossRef

Scali ST, Vlada A, Chang CK, Beck AW. Transcaval embolization as an alternative technique for the treatment of type II endoleak after endovascular aortic aneurysm repair. J Vasc Surg. 2013;57:869–74.CrossRefPubMedPubMedCentral

Giles KA, Fillinger MF, De Martino RR, Hoel AW, Powell RJ, Walsh DB. Results of transcaval embolization for sac expansion from type II endoleaks after endovascular aneurysm repair. J Vasc Surg. 2015;61:1129–36.CrossRefPubMed

Aziz A, Menias CO, Sanchez LA, Picus D, Saad N, Rubin BG, et al. Outcomes of percutaneous endovascular intervention for type II endoleak with aneurysm expansion. J Vasc Surg. 2012;55:1263–7.CrossRefPubMed

Walker J, Tucker LY, Goodney P, Candell L, Hua H, Okuhn S, et al. Type II endoleak with or without intervention after endovascular aortic aneurysm repair does not change aneurysm-related outcomes despite sac growth. J Vasc Surg. 2015;62:551–61.CrossRefPubMed

10.

Patatas K, Ling L, Dunning J, Shrivastava V. Static sac size with a type II endoleak post-endovascular abdominal aortic aneurysm repair: surveillance or embolization? Interact CardioVasc Thorac Surg. 2012;15:462–6.CrossRefPubMedPubMedCentral

11.

Moll FL, Powell JT, Fraedrich G, Verzini F, Haulon S, Waltham M, et al. Management of abdominal aortic aneurysms clinical practice guidelines of the European Society for Vascular Surgery. Eur J Endovasc Surg. 2011;41:S1–58.

12.

Biebl M, Hakaim AG, Oldenburg WA, Klocker J, Lau LL, Neuhauser B, et al. Does chronic oral anticoagulation with warfarin affect durability of endovascular aortic aneurysm exclusion in a midterm follow-up? J Endovasc Ther. 2005;12:58–65.CrossRefPubMed

13.

Bobadilla JL, Hoch JR, Leverson GE, Tefera G. The effect of warfarin therapy on endoleak development after endovascular aneurysm repair (EVAR) of the abdominal aorta. J Vasc Surg. 2010;52:267–71.CrossRefPubMed

14.

De Rango P, Verzini F, Parlani G, Cieri E, Simonte G, Farchioni L, et al. Safety of chronic anticoagulation therapy after endovascular abdominal aneurysm repair (EVAR). Eur J Vasc Endovasc Surg. 2014;47:296–303.

15.

Lazarides MK, Georgiadis GS, Charalampidis DG, Antoniou GA, Georgakarakos E, Trellopoulos G. Impact of long-term warfarin treatment on EVAR durability: a meta-analysis. J Endovasc Ther. 2014;21:148–53.CrossRefPubMed

16.

Avgerinos ED, Chaer RA, Makaroun MS. Type II endoleaks. J Vasc Surg. 2014;60:1386–91.CrossRefPubMed

17.

Go MR, Barbato JE, Rhee RY, Makaroun MS. What is the clinical utility of a 6-month computed tomography in the follow-up of endovascular aneurysm repair patients? J Vasc Surg. 2008;47:1181–6.

18.

Sarac TP, Lina CG, Vargas L, Liu J, Srivastava S, Bena J, et al. Long-term follow-up of type II endoleak embolization reveals the need for close surveillance. J Vasc Surg. 2012;55:33–40.CrossRefPubMed

Titel: A multi-institutional survey of interventional radiology for type II endoleaks after endovascular aortic repair: questionnaire results from the Japanese Society of Endoluminal Metallic Stents and Grafts in Japan
verfasst von: Yukihisa Ogawa
Hiroshi Nishimaki
Keigo Osuga
Osamu Ikeda
Norio Hongo
Shinichi Iwakoshi
Ryota Kawasaki
Reiko Woodhams
Masato Yamaguchi
Mika Kamiya
Masayuki Kanematsu
Masanori Honda
Toshio Kaminou
Jun Koizumi
Kimihiko Kichikawa
Publikationsdatum: 04.06.2016
Verlag: Springer Japan
Erschienen in: Japanese Journal of Radiology / Ausgabe 8/2016
Print ISSN: 1867-1071
Elektronische ISSN: 1867-108X
DOI: https://doi.org/10.1007/s11604-016-0558-y

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A multi-institutional survey of interventional radiology for type II endoleaks after endovascular aortic repair: questionnaire results from the Japanese Society of Endoluminal Metallic Stents and Grafts in Japan