Translumbar embolization of type 2 endoleaks after endovascular repair of abdominal aortic aneurysms.

摘要: ENDOVASCULAR repair of abdominal aortic aneurysms is a rapidly proliferating technique. Unlike conventional “open” aneurysm repairs, patients may develop immediate or delayed “endoleaks” requiring remediation either by catheter-based surgical intervention. Endoleaks are classified into one four categories (1,2). A leak at an attachment site (proximal, middle, distal) as type 1. In collateral endoleaks (type 2), blood travels from branch vessel in the nonstented portion aorta iliac arteries. Blood flow then takes circuitous route, emptying sac via retrograde through lumbar artery, inferior mesenteric other originating aneurysm. This most common and unrelated to configuration stent-graft used. that result defect in, failure of, graft material defined 3, whereas those resulting wall porosity called 4. Most controversial fate 2) endoleaks, usually arising artery excluded sac. While some these leaks have been demonstrated thrombose with passage time, distressing reports continued enlargement untreated accumulating (3–5). One barriers catheterbased 2 has access offending supplying Access can be gained catheterization superior selecting collaterals. approach tedious, time-consuming, not always successful, particularly if there incomplete arc connecting SMA-IMA axis (6– 10). Patent arteries even less easily accessed. Translumbar was first introduced more than 70 years ago (11,12). Modifications made this technique clinical value 1960s (13). Even though long history safety procedure well documented, present translumbar angiography reserved for poor peripheral vascular access. The purpose our investigation feasibility direct puncture endoleak embolization approach. MATERIALS AND METHODS