A Novel Technique for the Treatment of Type 2 Endoleak After Endovascular Aortic Repair: Sac Embolization with Balloon Occlusion of the Aorta (SEBOA)

Cardiovascular and Interventional Radiology
Yukihisa OgawaTakeshi Miyairi

Abstract

We presented a new method of sac embolization using n-butyl-cyanoacrylate (NBCA) with balloon occlusion of the aorta (SEBOA) that can facilitate decreasing flow rate of the involved branches with the goal of type 2 endoleak resolution after endovascular aortic repair (EVAR). This technique is demonstrated in six patients who required type 2 endoleak treatment including previous technical failure. A transarterial approach was performed in four patients and transabdominal direct puncture in two. Technical success was defined as complete embolization of both involved branches and sac on postoperative CT. Sacography under balloon occlusion of the aorta demonstrated decreased flow rate of the all involved branches in all patients. SEBOA was performed using 25 or 33% of NBCA diluted with lipiodol. Technical success was obtained in 3 of 6 patients, and one major complication was observed with adhesion of NBCA to the microcatheter resulting in foreign body retention. SEBOA may help solve the difficulty of type 2 endoleak treatment after EVAR as decreased flow rate of the involved branches under balloon occlusion of the aorta was achieved in all patients. However, protocols regarding concentration of NBCA or using other embolic material...Continue Reading

References

Oct 30, 2012·Journal of Vascular and Interventional Radiology : JVIR·Nobuyuki KawaiTetsuo Sonomura
Dec 21, 2016·Journal of Vascular and Interventional Radiology : JVIR·Hyeon YuCharles T Burke
Jun 27, 2018·Journal of Vascular and Interventional Radiology : JVIR·Rebecca ZenerKong Teng Tan
Aug 15, 2018·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Klaas H J UlteeHence J M Verhagen

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