Tratamiento endovascular del aneurisma de aorta: endoleaks tipo ii, cuándo y cómo tratarlos

Abstract

IntroductionThe treatment of type ii endoleaks remains controversial. Their long-term natural history and impact on changes in aneurysm morphology are still under review. ObjectiveThe objective of this study is to present a safe and effective approach to treat type ii endoleaks associated to aneurysm sac enlargement. Material and methodOut of a total of 214 patients, 32 presented with a type II endoleak in the first post-surgical review. Fifteen of these developed a persistent endoleak, but only 11 of them were associated with growth of the aneurysm sac. The treatment consisted of coil embolisation of the lumbar arteries (8 cases), lumbar puncture (one case), embolisation of the inferior mesenteric artery (IMA) (one case), and laparoscopic IMA ligation (one case). The data were analysed using the Medcalc v. 11 statistics package. ResultsBy transarterial or laparoscopic techniques effective treatment was obtained of endoleak, evidenced by its stabilization thrombosis and aneurysm sac in successive tomographic controls. No mortality or reoperation related rupture occurred. ConclusionOnly those patients with persistent typeII endoleak associated with sac enlargement should be treated. Effective techniques were described.