Off-label intravascular uses of embolic glue: how we avoid sticky situations

No. 461 Does billowing of the Endologix Powerlink Stent Graft correlate with decrease in aneurysm sac size? N. Helo, W. Wang, A. Chang, C. Hyun, K. Chon, A. Yi; Loma Linda University Medical Center, Loma Linda, CA; Jacksonville, FL; VA Loma Linda Healthcare System, Loma Linda, CA; Loma Linda Veterans Hospital, Loma Linda, CA; Anaheim, CA Purpose: Billowing is unique to the Endologix stent graft where a crescentic rim of contrast is seen outside the metallic endoskeleton but is still contained within the outer plastic graft as the graft is not attached to the metallic endoskeleton at all points. Contrast within the potential space visualized on imaging is termed billowing. Previous studies have shown high incidence of billowing in patients but have not shown correlation between billowing and change in aneurysm sac size. The objective is to determine if billowing with patients with the Endologix Powerlink Stent Graft correlates with a decrease in aneurysm sac size. Materials: After our IRB approval, a chart review of imaging and progress notes of 122 consecutive patients with placement of the Endologix stent graft from 2009-2012 was performed. We have an extensive imaging follow-up program of patients that have EVAR performed. Two attending radiologists and a radiology resident individually reviewed the imaging and recorded data. The data was then analyzed with statistics to prove correlations. Results: 100 patients had follow-up imaging in which 84 patients had billowing. An independent T-test showed that there is a statistical difference in the absolute change in size of the aneurysm sac size in AP and transverse dimensions as well as the percent change of the aneurysm sac size in transverse dimension in billowing versus non-billowing groups (P1⁄4 0.014, 0.009, 0.006 respectively). The independent T-Test showed no statistical difference in the percent change of aneurysm sac size in AP dimension in billowing versus non-billowing groups (P1⁄40.059). Conclusions: Billowing helps reduce aneurysm sac size in absolute change in size of the aneurysm sac size in AP and transverse dimensions as well as the percent change of aneurysm sac size in transverse dimension.