Top

Published in:

Open Access 01-12-2019 | Aneurysm | Review

Techniques and future perspectives for the prevention and treatment of endoleaks after endovascular repair of abdominal aortic aneurysms

Authors: Gianluigi Orgera, Marcello Andrea Tipaldi, Florindo Laurino, Pierleone Lucatelli, Alberto Rebonato, Ioannis Paraskevopoulos, Michele Rossi, Miltiadis Krokidis

Published in: Insights into Imaging | Issue 1/2019

Abstract

The presence of endoleaks remains one of the main drawbacks of endovascular repair of abdominal aortic aneurysms leading to the increase of the size of the aneurysmal sac and in most of the cases to repeated interventions. A variety of devices and percutaneous techniques have been developed so far to prevent and treat this phenomenon, including sealing of the aneurysmal sac, endovascular embolisation, and direct sac puncture. The aim of this review is to analyse the indications, the effectiveness, and the future perspectives for the prevention and treatment of endoleaks after endovascular repair of abdominal aortic aneurysms.

Parodi JC, Palmaz JC, Barone HD (1991) Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg 5:491–499PubMedCrossRef

White GH, Yu WJ, May J, Chaufour X, Stephen MS (1997) Endoleak as a complication of endoluminal grafting of abdominal aortic aneurysms: classification, incidence, diagnosis, and management. J Endovasc Surg 4:152–168PubMedCrossRef

Orandi BJ, Dimick JB, Deeb GM, Patel HJ, Upchurch GR Jr (2009) A population-based analysis of endovascular versus open thoracic aortic aneurysm repair. J Vasc Surg 49:1112–1116PubMedCrossRef

Drury D, Michaels JA, Jones L, Ayiku L (2005) Systematic review of recent evidence for the safety and efficacy of elective endovascular repair in the management of infrarenal abdominal aortic aneurysm. Br J Surg 92:937–946PubMedCrossRef

Prinssen M, Buskens E, de Jong SE et al (2007) Cost-effectiveness of conventional and endovascular repair of abdominal aortic aneurysms: results of a randomized trial. J Vasc Surg 46:883–890PubMedCrossRef

Lederle FA, Freischlag JA, Kyriakides TC et al (2009) Open Versus Endovascular Repair (OVER) Veterans Affairs Cooperative Study Group. Outcomes following endovascular vs open repair of abdominal aortic aneurysm: a randomized trial. JAMA 302(14):1535–1542

Powell JT, Sweeting MJ, Ulug P et al (2017) Meta-analysis of individual-patient data from EVAR-1, DREAM, OVER and ACE trials comparing outcomes of endovascular or open repair for abdominal aortic aneurysm over 5 years. Br J Surg. 104(3):166–178PubMedCrossRef

Paravastu SC, Jayarajasingam R, Cottam R, Palfreyman SJ, Michaels JA, Thomas SM (2014) Endovascular repair of abdominal aortic aneurysm. Cochrane Database Syst Rev 23:CD004178

Patel R, Sweeting MJ, Powell JT, Greenhalgh RM, EVAR trial investigators (2016) Endovascular versus open repair of abdominal aortic aneurysm in 15-years’ follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial. Lancet 388(10058):2366–2374PubMedCrossRef

10.

Kouvelos GN, Oikonomou K, Antoniou GA, Verhoeven EL, Katsargyris A (2017) A systematic review of proximal neck dilatation after endovascular repair for abdominal aortic aneurysm. J Endovasc Ther. 24(1):59–67PubMedCrossRef

11.

Antoniou GA, Smyth JV, Antoniou SA, Serracino-Inglott F, Murray D (2012) Endoleak is the Achilles’ heel of the chimney technique for the treatment of complex aortic disease. Int Angiol 31(6):595–596PubMed

12.

Massimi TM, Kostun ZW, Woo EY (2017) Transcaval embolization of a type I gutter endoleak after three-vessel chimney endovascular aneurysm repair. J Vasc Surg. 65(5):1515–1517PubMedCrossRef

13.

Zaiem F, Almasri J, Tello M, Prokop LJ, Chaikof EL, Murad MH (2018) A systematic review of surveillance after endovascular aortic repair. J Vasc Surg 67(1):320-331.e37PubMedCrossRef

14.

Ullery BW, Tran K, Itoga NK, Dalman RL, Lee JT (2017) Natural history of gutter-related type Ia endoleaks after snorkel/chimney endovascular aneurysm repair. J Vasc Surg. 65(4):981–990PubMedPubMedCentralCrossRef

15.

Quinn AA, Mehta M, Teymouri MJ et al (2017) The incidence and fate of endoleaks vary between ruptured and elective endovascular abdominal aortic aneurysm repair. J Vasc Surg. 65(6):1617–1624PubMedCrossRef

16.

Maleux G, Poorteman L, Laenen A et al (2017) Incidence, etiology, and management of type III endoleak after endovascular aortic repair. J Vasc Surg. 66(4):1056–1064PubMedCrossRef

17.

Dudeck O (2013) Endoleaks - when is treatment necessary? [Article in German]. Radiologe. 53(6):526–530PubMedCrossRef

18.

Sidloff DA, Gokani V, Stather PW, Choke E, Bown MJ, Sayers RD (2014) Type II endoleak: conservative management is a safe strategy. Eur J Vasc Endovascular Surg 48(4):391–399CrossRef

19.

Kuziez MS, Sanchez LA, Zayed MA (2016) Abdominal aortic aneurysm type II endoleaks. J Cardiovasc Dis Diagn 4:5CrossRef

20.

El Batti S, Cochennec F, Roudot-Thoraval F, Becquemin JP (2013) Type II endoleaks after endovascular repair of abdominal aortic aneurysm are not always a benign condition. J Vasc Surg 57(5):1291–1297PubMedCrossRef

21.

Cieri E, De Rango P, Isernia G et al (2015) Type II endoleak is an enigmatic and unpredictable marker of worse outcome after endovascular aneurysm repair. J Vasc Surg. 59(4):930–937CrossRef

22.

Lo RC, Buck DB, Herrmann J et al (2016) Risk factors and consequences of persistent type II endoleaks. J Vasc Surg. 63(4):895–901PubMedPubMedCentralCrossRef

23.

Moulakakis KG, Klonaris C, Kakisis J et al (2016) Treatment of type II endoleak and aneurysm expansion after EVAR. Ann Vasc Surg [Epub ahead of print]

24.

Mangialardi N, Orrico M, Ronchey S, Praquin B, Alberti V, Setacci C (2016) Towards an entirely endovascular aortic world: an update of techniques and outcomes for endovascular and open treatment of type I, II, and III endoleaks. J Cardiovasc Surg (Torino). 57(5):698–711

25.

Abdulrasak M, Resch T, Sonesson B, Holst J, Kristmundsson T, Dias NV (2017) The long-term durability of intra-operatively placed Palmaz stents for the treatment of type Ia endoleaks after EVAR of abdominal aortic aneurysm. Eur J Vasc Endovascular Surg 53(1):69–76PubMedCrossRef

26.

Schlösser FJV, de Vries JPPM, Chaudhuri A (2017) Is it time to insert endoanchors into routine EVAR? Eur J Vasc Endovascular Surg 53(4):458–459PubMedCrossRef

27.

Montelione N, Pecoraro F, Puippe G et al (2015) A 12-year experience with chimney and periscope grafts for treatment of type I endoleaks. J Endovasc Ther. 22(4):568–574PubMedCrossRef

28.

Bianchini Massoni C, Mascoli C, Perini P et al (2018) Endovascular treatments for type Ib endoleaks after aorto-iliac aneurysms exclusion: mid-term results. Int Angiol. 37(5):384–389PubMedCrossRef

29.

Naughton PA, Garcia-Toca M, Rodriguez HE et al (2011) Endovascular treatment of delayed type 1 and 3 endoleaks. Cardiovasc Intervent Radiol. 34(4):751–757PubMedCrossRef

30.

Ward TJ, Cohen S, Fischman AM et al (2013) Preoperative inferior mesenteric artery embolization before endovascular aneurysm repair: decreased incidence of type II endoleak and aneurysm sac enlargement with 24-month follow-up. J Vasc Interv Radiol. 24(1):49–55PubMedCrossRef

31.

Alerci M, Giamboni A, Wyttenbach R et al (2013) Endovascular abdominal aneurysm repair and impact of systematic preoperative embolization of collateral arteries: endoleak analysis and long-term follow-up. J Endovasc Ther. 20(5):663–671PubMedCrossRef

32.

Piazza M, Frigatti P, Scrivere P et al (2013) Role of aneurysm sac embolization during endovascular aneurysm repair in the prevention of type II endoleak-related complications. J Vasc Surg. 57(4):934–941PubMedCrossRef

33.

Biancari F, Mäkelä J, Juvonen T, Venermo M (2015) Is inferior mesenteric artery embolization indicated prior to endovascular repair of abdominal aortic aneurysm? Eur J Vasc Endovascular Surg 50(5):671–674PubMedCrossRef

34.

Manunga JM, Cragg A, Garberich R et al (2017) Preoperative inferior mesenteric artery embolization: a valid method to reduce the rate of type II endoleak after EVAR? Ann Vasc Surg 39:40-47.PubMedCrossRef

35.

Quinones-Baldrich W, Levin ES, Lew W, Barleben A (2014) Intraprocedural and postprocedural perigraft arterial sac embolization (PASE) for endoleak treatment. J Vasc Surg. 59(2):538–541PubMedCrossRef

36.

Zanchetta M, Faresin F, Pedon L, Ronsivalle S (2007) Intraoperative intrasac thrombin injection to prevent type II endoleak after endovascular abdominal aortic aneurysm repair. J Endovasc Ther. 14(2):176–183PubMedCrossRef

37.

Muthu C, Maani J, Plank LD, Holden A, Hill A (2007) Strategies to reduce the rate of type II endoleaks: routine intraoperative embolization of the inferior mesenteric artery and thrombin injection into the aneurysm sac. J Endovasc Ther. 14(5):661–668PubMedCrossRef

38.

Samura M, Morikage N, Mizoguchi T et al (2018) Effectiveness of embolization of inferior mesenteric artery to prevent type II endoleak following endovascular aneurysm repair: a review of the literature. Ann Vasc Dis 11(3):259–264PubMedPubMedCentralCrossRef

39.

Holden A (2014) Endovascular aneurysm sealing for abdominal aortic aneurysm repair: evolution or revolution? Cardiovasc Intervent Radiol. 37(5):1129–1136PubMedCrossRef

40.

Böckler D, Holden A, Thompson M et al (2015) Multicenter Nellix endovascular aneurysm sealing system experience in aneurysm sac sealing. J Vasc Surg 62:290–298PubMedCrossRef

41.

Brownrigg JR, DeBruin JL, Rossi L et al (2015) Endovascular aneurysm sealing for infrarenal abdominal aortic aneurysms: 30-day outcomes of 105 patients in a single centre. Eur J Vasc Endovascular Surg 50:157–164PubMedCrossRef

42.

Zerwes S, Nurzai Z, Leissner G et al (2016) Early experience with the new endovascular aneurysm sealing system Nellix: first clinical results after 50 implantations. Vascular 24:339–347PubMedCrossRef

43.

Reijnen MM, de Bruin JL, Mathijssen EG et al (2016) Global experience with the Nellix endosystem for ruptured and symptomatic abdominal aortic aneurysms. J Endovasc Ther 23:21–28PubMedCrossRef

44.

Carpenter JP, Cuff R, Buckley C et al (2016) Results of the Nellix system investigational device exemption pivotal trial for endovascular aneurysm sealing. J Vasc Surg 63:23–31PubMedCrossRef

45.

Abularrage CJ, Patel VI, Conrad MF, Schneider EB, Cambria RP, Kwolek CJ (2012) Improved results using Onyx glue for the treatment of persistent type 2 endoleak after endovascular aneurysm repair. J Vasc Surg. 56(3):630–636PubMedCrossRef

46.

Güntner O, Zeman F, Wohlgemuth WA et al (2014) Inferior mesenteric arterial type II endoleaks after endovascular repair of abdominal aortic aneurysm: are they predictable? Radiology 270(3):910–919PubMedCrossRef

47.

Ribé L, Bicknell CD, Gibbs RG et al (2017) Long-term results of intra-arterial onyx injection for type II endoleaks following endovascular aneurysm repair. Vascular 25(3):266-271PubMedCrossRef

48.

Baum RA, Cope C, Fairman RM, Carpenter JP (2001) Translumbar embolization of type 2 endoleaks after endovascular repair of abdominal aortic aneurysms. J Vasc Interv Radiol 12(1):111–116PubMedCrossRef

49.

Stavropoulos SW, Carpenter JP, Fairman RM, Golden MA, Baum RA (2003) Inferior vena cava traversal for translumbar endoleak embolization after endovascular abdominal aortic aneurysm repair. J Vasc Interv Radiol 14(9, Pt 1):1191–1194PubMedCrossRef

50.

Van Bindsbergen L, Braak SJ, van Strijen MJ, de Vries JP (2010) Type II endoleak embolization after endovascular abdominal aortic aneurysm repair with use of real-time three-dimensional fluoroscopic needle guidance. J Vasc Interv Radiol 21(9):1443–1447PubMedCrossRef

51.

Chung R, Morgan RA (2015) Type 2 Endoleaks Post-EVAR: Current evidence for rupture risk, intervention and outcomes of treatment. Cardiovasc Intervent Radiol. 38(3):507–522PubMedCrossRef

52.

Scali ST, Vlada A, Chang CK, Beck AW (2013) Transcaval embolization as an alternative technique for the treatment of type II endoleak after endovascular aortic aneurysm repair. J Vasc Surg 57:869–874PubMedPubMedCentralCrossRef

53.

Mansueto G, Cenzi D, Scuro A et al (2007) Treatment of type II endoleak with a transcatheter transcaval approach: results at 1-year follow-up. J Vasc Surg 45:1120–1127PubMedCrossRef

54.

Giles KA, Fillinger MF, De Martino RR, Hoel AW, Powell RJ, Walsh DB (2015) Results of transcaval embolization for sac expansion from type II endoleaks after endovascular aneurysm repair. J Vasc Surg. 61(5):1129–1136PubMedCrossRef

55.

Ogawa Y, Hamaguchi S, Nishimaki H et al (2015) Embolization by direct puncture with a transpedicular approach using an isocenter puncture (ISOP) method in a patient with a type II endoleak after endovascular aortic repair (EVAR). Cardiovasc Intervent Radiol. 38(3):731–735PubMedCrossRef

56.

Uthoff H, Katzen BT, Gandhi R, Peña CS, Benenati JF, Geisbüsch P (2012) Direct percutaneous sac injection for postoperative endoleak treatment after endovascular aortic aneurysm repair. J Vasc Surg 56:965–972PubMedCrossRef

57.

Yang RY, Tan KT, Beecroft JR, Rajan DK, Jaskolka JD (2017) Direct sac puncture versus transarterial embolization of type II endoleaks: an evaluation and comparison of outcomes. Vascular 25(3):227-233PubMedCrossRef

58.

Chaikof EL, Blankensteijn JD, Harris PL et al (2002) Reporting standards for endovascular aortic aneurysm repair. J Vasc Surg 35:1048–1060PubMedCrossRef

59.

Verma H, Meda N, Tripathi RK (2014) Management of complex type Iiia endoleak by brachio-femoral realignment and interposition stent graft and review of the literature. Indian J Vasc Endovascular Surg 1:29–32CrossRef

60.

Oderich GS (2011) Reporting on fenestrated endografts: surrogates for outcomes and implications of aneurysm classification, type of repair, and the evolving technique. J Endovasc Ther 18:154–156PubMedCrossRef

61.

Faries PL, Cadot H, Agarwal G, Kent KC, Hollier LH, Marin ML (2003) Management of endoleak after endovascular aneurysm repair: cuffs, coils, and conversion. J Vasc Surg. 37:1155–1161PubMedCrossRef

62.

Espinosa G, Ribeiro Alves M, Ferreira Caramalho M, Dzieciuchowicz L, Santos SR (2009) A 10-year single-center prospective study of endovascular abdominal aortic aneurysm repair with the talent stent-graft. J Endovasc Ther. 16:125–135PubMedCrossRef

63.

Espinosa G, Ribeiro M, Riguetti C, Caramalho MF, Mendes WD, Santos SR (2005) Six-year experience with talent stent-graft repair of abdominal aortic aneurysms. J Endovasc Ther. 12:35–45PubMedCrossRef

64.

Forbes TL, Harrington DM, Harris JR, DeRose G (2012) Late conversion of endovascular to open repair of abdominal aortic aneurysms. Can J Surg. 55:254–258PubMedPubMedCentralCrossRef

65.

Klonaris C, Lioudaki S, Katsargyris A et al (2014) Late open conversion after failed endovascular aortic aneurysm repair. J Vasc Surg. 59(2):291–297PubMedCrossRef

66.

Kouvelos G, Koutsoumpelis A, Lazaris A, Matsagkas M (2015) Late open conversion after endovascular abdominal aortic aneurysm repair. J Vasc Surg. 61(5):1350–1356PubMedCrossRef

67.

Gilling-Smith G, Brennan J, Harris P, Bakran A, Gould D, McWilliams R (1999) Endotension after endovascular aneurysm repair: definition, classification, and strategies for surveillance and intervention. J Endovasc Surg 6:305e7CrossRef

68.

Trocciola SM, Dayal R, Chaer RA et al (2006) The development of endotension is associated with increased transmission of pressure and serous components in porous expanded polytetra-fluoroethylene stent-grafts: characterization using a canine model. J Vasc Surg 43(1):109–116PubMedCrossRef

69.

Cho J-S, Park T, Kim JY, Chaer RA, Rhee RY, Makaroun MS (2010) Prior endovascular abdominal aneurysm repair provides no survival benefits when the aneurysm ruptures. J Vasc Surg 52:1127e34

70.

Kougias P, Lin PH, Dardik A, Lee WA, El Sayed HF, Zhou W (2007) Successful treatment of endotension and aneurysm sac enlargement with endovascular stent graft reinforcement. J Vasc Surg 46:124e7PubMedCrossRef

71.

Moll FL, Powell JT, Fraedrich G et al (2011) Management of abdominal aortic aneurysms clinical practice guidelines of the European Society for Vascular Surgery. Eur J Vasc Endovascular Surg 41(Suppl 1):S1e58

72.

Koole D, Moll FL, Buth J et al (2011) Annual rupture risk of abdominal aortic aneurysm enlargement without detectable endoleak after endovascular abdominal aortic repair. J Vasc Surg 54:1614e22CrossRef

73.

Chandarana H, Godoy MC, Vlahos I et al (2008) Abdominal aorta: evaluation with dual-source dual-energy multidetector CT after endovascular repair of aneurysms – initial observations. Radiology. 249(2):692–700PubMedCrossRef

74.

Nevala T, Biancari F, Manninen H et al (2010) Type II endoleak after endovascular repair of abdominal aortic aneurysm: effectiveness of embolization. Cardiovasc Intervent Radiol 33(2):278–284PubMedCrossRef

75.

Massis K, Carson WG 3rd, Rozas A, Patel V, Zwiebel B (2012) Treatment of type II endoleaks with ethylene-vinyl-alcoholcopolymer (Onyx). Vasc Endovascular Surg 46(3):251–257PubMedCrossRef

Title: Techniques and future perspectives for the prevention and treatment of endoleaks after endovascular repair of abdominal aortic aneurysms
Authors: Gianluigi Orgera
Marcello Andrea Tipaldi
Florindo Laurino
Pierleone Lucatelli
Alberto Rebonato
Ioannis Paraskevopoulos
Michele Rossi
Miltiadis Krokidis
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Keywords: Aneurysm
Aneurysm
Abdominal Aortic Aneurysm
Abdominal Aortic Aneurysm
Published in: Insights into Imaging / Issue 1/2019
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-019-0774-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Techniques and future perspectives for the prevention and treatment of endoleaks after endovascular repair of abdominal aortic aneurysms

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2019

A radiologic review of hoarse voice from anatomic and neurologic perspectives

Visible T1-hyperintensity of the dentate nucleus after multiple administrations of macrocyclic gadolinium-based contrast agents: yes or no?

Imaging of shoulder arthroplasties and their complications: a pictorial review

A systematic review on the use of the breast lesion excision system in breast disease

Elucidating vaginal fistulas on CT and MRI

An update on Burkitt lymphoma: a review of pathogenesis and multimodality imaging assessment of disease presentation, treatment response, and recurrence