Transgraft sac Embolization Combined with Graft Reinforcement for Refractory Mixed-Type Endoleak

Motoki Nakai (1) , Akira Ikoma (1) , Romaric Loffroy (2) , Marco Midulla (3, 2) , Pramod Rao (2) , Atsufumi Kamisako (1) , Nobuyuki Higashino (1) , Kodai Fukuda (1) , Tetsuo Sonomura (1)

1 Department of radiology
2 Department vascular, oncologic ans interventional radiology (CHU de Dijon)
3 Le2i - Laboratoire d'Electronique, d'Informatique et d'Image [EA 7508]

An 80-year-old female underwent EVAR 4 years ago. She presented type II endoleak with sac expansion from 68 to 80 mm during 3-year follow-up after EVAR. Although she underwent translumbar percutaneous sac embolization, the AAA sac continued to enlarge, suggesting mixed-type endoleak including type I, II, and III. Transgraft direct sac angiography revealed endoleak cavity without demonstrable feeding vessel. Transgraft sac embolization using n-butyl cyanoacrylate and graft reinforcement was performed concurrently, without complications. The graft reinforcement consisted of graft extension for eliminating occult type I endoleak, and relining for eliminating occult type III endoleak. Six months after the procedure, CT showed no signs of sac expansion. Transgraft sac embolization combined with graft reinforcement is one of the available options for persistent and refractory mixed-type endoleak.

Mots clés: Transgraft sac embolization; Mixed-type endoleak; EVAR; n-butyl cyanoacrylate; Graft reinforcement

Domaines: Ingénierie biomédicale; Cardiologie et système cardiovasculaire

Motoki Nakai, Akira Ikoma, Romaric Loffroy, Marco Midulla, Pramod Rao, et al.. Transgraft sac Embolization Combined with Graft Reinforcement for Refractory Mixed-Type Endoleak. CardioVascular and Interventional Radiology, 2018, pp.1-5. ⟨hal-01998719⟩