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Long-Term Outcomes Following Transarterial Embolisation of Proximal Type I Endoleaks Post-EVAR

  • Clinical Investigation
  • Arterial Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To describe the long-term outcomes following transarterial embolisation for type Ia endoleaks (ELIa) in patients who failed or were unsuitable for standard endovascular/surgical options.

Materials and Methods

A retrospective single-centre observational study was performed between October 2010 and April 2018. Technical success rates and long-term outcomes were evaluated. A sub-analysis was performed comparing outcomes of covered aortic endografts and Nellix endovascular aneurysm sealing systems.

Results

A total of 34 transcatheter embolisations were performed for ELIa in 27 patients (13 endografts and 14 patients with Nellix systems). A combination of Onyx and coils was used most frequently (18/34), followed by Onyx alone (14/34) and coils alone (2/34). Technical success was achieved in 33/34 (97%) procedures . Seven early complications occurred with no immediate mortality, 5 of which involved migration/reflux of embolic into the endograft—all successfully managed via endovascular approach. Following the surveillance period (mean 25 months), 13/26 (50%) of patients were free from recurrent endoleak. Sac expansion occurred in 42% (11/26). 21/26 patients died; 6 due to aneurysm sac rupture, 10 due to unrelated causes, and 5 had no cause of death available. No significant difference in survival was found between patients with an endograft or Nellix graft—Chi-squared value − 0.011 (p < 0.05 = 3.84).

Conclusions

Transcatheter embolisation for type Ia endoleaks is a safe and effective option in a select patient cohort—where traditional endovascular and surgical options are unsuitable or have failed. The procedure may prevent recurrence in some whilst delaying rupture and death in others.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. St Georges Hospital NHS Foundation Trust, Blackshaw Road, Tooting, London, UK

    Shyamal Patel, Vyzantios Pavlidis, Seyed Ameli-Renani, Joo-Young Chun, Leto Mailli & Robert Morgan

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  1. Shyamal Patel
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  2. Vyzantios Pavlidis
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  3. Seyed Ameli-Renani
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  4. Joo-Young Chun
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  5. Leto Mailli
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  6. Robert Morgan
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Correspondence to Shyamal Patel.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval was sought, but for this type of study formal ethical approval was not required.

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Patel, S., Pavlidis, V., Ameli-Renani, S. et al. Long-Term Outcomes Following Transarterial Embolisation of Proximal Type I Endoleaks Post-EVAR. Cardiovasc Intervent Radiol 46, 428–435 (2023). https://doi.org/10.1007/s00270-022-03342-5

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  • DOI: https://doi.org/10.1007/s00270-022-03342-5

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