Does Successful Embolization of Endoleaks Lead to Aneurysm Sac Shrinkage?

Abstract

Purpose:

To determine whether embolization of endoleaks after endovascular repair of aortic aneurysms is associated with a decrease in the diameter of the aneurysm.

Methods:

Fifteen patients (13 men; median age 76 years) demonstrated primary endoleaks persisting ≥ 3 months after endovascular abdominal aortic aneurysm repair with a variety of commercial endografts. In 8 patients, coil embolization failed to completely obliterate the leak, whereas embolotherapy proved successful in the remaining 7 patients. Surveillance of endoleaks and the effect of their embolization on aneurysm size were followed with serial computed tomographic (CT) scans. Follow-up after embolization extended for at least 12 months.

Results:

Patients with persistent leak exhibited a slight increase in mean aneurysm area from 21.41 ± 4.25 to 22.47 ± 6.70 cm². Medians differed from 20.03 (range 16.59–28.73) to 23.03 (range 14.14–33.69) cm² (p = 0.0078, 95% confidence interval [CI] = 0.0075 to 0.0081). Successfully treated patients, however, showed a mean decrease from 20.58 ± 3.63 (median 19.87) to 16.36 ± 6.46 cm² (median 18.10) at 1 year (p = 0.0156, 95% CI = 0.0151 to 0.0160). The medians differed significantly between groups (p < 0.05).

Conclusions:

Persistent endoleaks after endovascular aortic aneurysm treatment led to an increase in the diameter of the aneurysm, whereas complete occlusion was associated with a significant decrease in aneurysm diameter.

Keywords

abdominal aortic aneurysm endovascular graft embolotherapy occlusion coils aneurysm diameter

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