Results of Transarterial Embolization for Treating Type 2 Endoleaks: A Single Center Experience

Abstract Introduction type 2 endoleaks (T2E) are the main cause of reintervention after endovascular repair of abdominal aortic aneurysms (EVAR). The objective of this study is to quantify success rates of T2E treatment Methods retrospective analysis of a prospectively-maintained database containing all consecutive patients treated for a T2E between 2003 and 2017 in a single center. Technical success was defined as absence of endoleak in the final angiographic control after treatment. Clinical success was defined as absence of sac growth over 5 mm in the contrast-enhanced computed tomography performed a year thereafter. Statistics included Kaplan Meier survival estimates. Results 528 elective EVAR were performed in the period. 36 of these (6.8%) developed a T2E requiring reintervention, a median of 37.9 months after EVAR. A 25.0% of the treatments were performed more than 5 years postintervention. 28 of the 36 treatments were performed via transarterial embolization. For this technique, technical success was of 71.4% and clinical success of 62.5%. A 35.7% of patients required a subsequent reintervention. In this cohort, the rate of aneurysm rupture was 10.7% (n=3/28), open surgical conversion was needed in a 7.1% (n=2/28) and aneurysm-related death was of 14.3% (n=4/28) over follow-up. Conclusion a high percentage of patients are at risk of adverse outcomes after T2E treatment. Strict imaging follow-up is still needed in this population.