Long-term efficacy of fibrin sealant treating proximal type I endoleak after endovascular aneurysm repair in abdominal aortic aneurysm

Abstract

Objective To observe the long-term efficacy of human fibrin sealant (FS) in the treatment of proximal type Ⅰ endoleak after endovascular aneurysm repair (EVAR) in abdominal aortic aneurysm (AAA). Methods The clinical data of 104 AAA patients with proximal type Ⅰ endoleak receiving EVAR+ FS in Changhai Hospital from 2003 to 2012 was retrospectively analyzed, among those 77 cases were with less than 15 mm proximal neck , 21 cases with greater than 60 degrees proximal neck angulation, 37 cases with severe calcification or thrombosis in proximal neck. After failure of conventional endoleak therapy FS was injected through AAA catheter and long-term efficacy was evaluated by CTA during the follow-up. Results Intra-sac pressure decreased significantly after FS injection. Three patients(2.9%)died perioperatively.Postoperative 1′- , 3′ and 5 year survival rate was 91.8%, 80.6% and 60.2% respectively. Maximum diameter of AAA decreased from (58.78±13.41)mm to (52.6±12.2) mm. There was no FS injection related complications. Conclusion Intra-sac injection of FS is an effective, economical and safe method for treating post-EVAR endoleak, especially for AAA with relatively short and twisted aneurysm neck. Key words: Fibrin tissue adhensive; Aorta aneurysm, abdominal; Endoleak; Endovascular aneurysm repair