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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 10/2019

01-10-2019 | Aneurysm | Technical Note

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

Authors: Yukihisa Ogawa, Hiroshi Nishimaki, Keishi Fujiwara, Itoga K. Nathan, Tomotaka Iraha, Kiyoshi Chiba, Akiyuki Kotoku, Takaaki Maruhashi, Hidefumi Mimura, Takeshi Miyairi

Published in: CardioVascular and Interventional Radiology | Issue 10/2019

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Abstract

Purpose

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).

Technique

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.

Conclusion

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.
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Ogawa Y, Nishimaki H, Osuga K, et al. A multi-institutional survey of interventional radiology for type II endoleaks after endovascular aortic repair: questionnaire results from the Japanese Society of Endoluminal Metallic Stents and Grafts in Japan. Jpn J Radiol. 2016;34:564–71.CrossRefPubMed
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Metadata
Title
A Novel Technique for the Treatment of Type 2 Endoleak After Endovascular Aortic Repair: Sac Embolization with Balloon Occlusion of the Aorta (SEBOA)
Authors
Yukihisa Ogawa
Hiroshi Nishimaki
Keishi Fujiwara
Itoga K. Nathan
Tomotaka Iraha
Kiyoshi Chiba
Akiyuki Kotoku
Takaaki Maruhashi
Hidefumi Mimura
Takeshi Miyairi
Publication date
01-10-2019
Publisher
Springer US
Keywords
Aneurysm
Aneurysm
Published in
CardioVascular and Interventional Radiology / Issue 10/2019
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-019-02299-2

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