Transarterial Embolization versus Translumber Embolization for Type II Endoleak after Endovascular Abdominal Aortic Aneurysm Repair: a Meta-Analysis

Abstract Objective Type II endoleak is the most common subtype of endoleak as a complication after endovascular aneurysm repair (EVAR). The efficacy of transarterial (TA) embolization and translumber (TL) embolization in the management of type II endoleak remains equipoise. The aim of this study is to compare the technical and clinical success between TA embolization and TL embolization for type II endoleak after EVAR. Methods The protocol was registered (CRD 42018114453) and the electronic databases (Pubmed, Embase, Web of Science, and Cochrane) were systematically searched till March 2019. The search terms included EVAR, type II endoleak, and embolization. The articles were read and extracted by two authors independently to include randomized control trails and retrospective studies that compared TA embolization and TL embolization in patients who developed type II endoleak after EVAR. The technical and clinical success rates were meta-analyzed with random effect model. Results A total of 6 articles with 268 patients and 290 type II endoleaks were included. The pooled odds ratio (OR) of technical success rate for TA vs. TL was 0.56 (95% CI, 0.10-3.18; P = 0.51) and the pooled OR of clinical success rate for TA vs. TL was 0.31(95% CI, 0.07-1.29; P = 0.11). As a limitation, 6 articles were all retrospective studies which may lead to bias. Conclusion Both TA and TL could be effective procedure of embolizations to resolve the type II endoleak. The meta-analysis result indicated that TA embolization was not inferior to TL embolization in technical success and clinical success.