1. A Novel Technique for the Treatment of Type 2 Endoleak After Endovascular Aortic Repair: Sac Embolization with Balloon Occlusion of the Aorta (SEBOA)
- Author
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Yukihisa Ogawa, Tomotaka Iraha, Akiyuki Kotoku, Hiroshi Nishimaki, Takeshi Miyairi, Hidefumi Mimura, Kiyoshi Chiba, Itoga K. Nathan, Keishi Fujiwara, and Takaaki Maruhashi
- Subjects
Male ,medicine.medical_specialty ,Endoleak ,medicine.medical_treatment ,Adhesion (medicine) ,Aortic repair ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Ethiodized Oil ,medicine.artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Embolization ,Aorta ,Aged ,business.industry ,Ultrasound ,Endovascular Procedures ,Balloon Occlusion ,Enbucrilate ,medicine.disease ,Embolization, Therapeutic ,Surgery ,Aortic Aneurysm ,Treatment Outcome ,Balloon occlusion ,Lipiodol ,Female ,Foreign body ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed ,medicine.drug - 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 materials are needed to improve the success rate.
- Published
- 2019