Purpose. The purpose of this study is to present an alternative technique for management of a type II endoleak associated with aneurysm sac enlargement. Technique. We report the use of a transseptal needle-sheath system for a transcatheter transcaval embolization (TTE) in a 3-staged treatment of a persistent type II endoleak after abdominal EVAR. Inferior vena cava is cannulated through a femoral venous access, and aneurysmal sac access is gained with a puncture through the walls of the 2 vessels at the site where the vein is adjacent to the aneurysm. The whole system (sheath-dilator-needle) is then advanced across the vascular walls into the aortic sac. Thus, embolization with glue is performed. Conclusion. The TTE using a transseptal needle-sheath system demonstrated to be feasible and effective to treat a persistent type II endoleak after failure of 2 attempts of transarterial embolization of the feeding vessels. © The Author(s) 2012.
Transcatheter transcaval embolization of a type II endoleak after EVAR using a transseptal needle-sheath system / Midulla, M., Perini, P., Sundareyan, R., Lazguet, Y., Dehaene, A., Goyault, G., Martinelli, T., Haulon, S.. - In: VASCULAR AND ENDOVASCULAR SURGERY. - ISSN 1538-5744. - 46:5(2012), pp. 410-413. [10.1177/1538574412448683]
Transcatheter transcaval embolization of a type II endoleak after EVAR using a transseptal needle-sheath system
Perini, Paolo;
2012-01-01
Abstract
Purpose. The purpose of this study is to present an alternative technique for management of a type II endoleak associated with aneurysm sac enlargement. Technique. We report the use of a transseptal needle-sheath system for a transcatheter transcaval embolization (TTE) in a 3-staged treatment of a persistent type II endoleak after abdominal EVAR. Inferior vena cava is cannulated through a femoral venous access, and aneurysmal sac access is gained with a puncture through the walls of the 2 vessels at the site where the vein is adjacent to the aneurysm. The whole system (sheath-dilator-needle) is then advanced across the vascular walls into the aortic sac. Thus, embolization with glue is performed. Conclusion. The TTE using a transseptal needle-sheath system demonstrated to be feasible and effective to treat a persistent type II endoleak after failure of 2 attempts of transarterial embolization of the feeding vessels. © The Author(s) 2012.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
