Abstract
Type II endoleak is a common complication following endovascular aortic aneurysm repair and can lead to an increased risk of aneurysmal expansion and rupture. The most frequently employed strategies to treat Type II endoleak involves catheterization of the branch vessels responsible for the endoleak or accessing the aneurysm sac through a percutaneous approach. An endovascular transcaval approach for embolization of the aneurysmal sac provides an alternate strategy with comparable success rates. This technique is advantageous when the endoleak is predominantly on the right side of the aneurysm sac and/or when a direct access to the aneurysm sac through a percutaneous approach is not feasible.
Highlights
Endovascular abdominal aortic aneurysm repair (EVAR) is the standard of care for the treatment of most aneurysms greater than 5.5 cm diameter (Yang et al, 2016)
Type 2 endoleak (T2E) is a common and often unavoidable complication resulting from incomplete exclusion of the aneurysm sac from the circulation via retrograde flow from branches of the abdominal aorta which can lead to aneurysm expansion and rupture
From the bilateral groins or groin and neck an intravascular ultrasound (IVUS) probe is used to direct the tip of a vascular sheath against the inferior vena cava (IVC) wall near the site of the type 2 endoleak (T2E)
Summary
Endovascular abdominal aortic aneurysm repair (EVAR) is the standard of care for the treatment of most aneurysms greater than 5.5 cm diameter (Yang et al, 2016). Type 2 endoleak (T2E) is a common and often unavoidable complication resulting from incomplete exclusion of the aneurysm sac from the circulation via retrograde flow from branches of the abdominal aorta which can lead to aneurysm expansion and rupture. The indication for treatment typically includes persistent endoleak (> 6 months) and continued sac expansion (> 0.5 cm) (Yamada et al, 2015; Ozdemir et al, 2013).
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