Effectiveness of Intra-operative Contrast-Enhanced Ultrasound Assessment to Optimize Type II Endoleak Embolization

• Type: Article in International Scientific Journal
• Date: 2024

Authors

Barbosa-Lima G.B. (Author) Other; Oderich G.S. (Author) Other; Dias-Neto M (Author) FMUP; Tenorio E.R. (Author) Other; Marcondes G.B. (Author) Other; Mendes B.C. (Author) Other; Ozbek P. (Author) Other; Macedo T.A. (Author) Other

Journal

The Journal is awaiting validation by the Administrative Services.

Title: CardioVascular and Interventional Radiology

Vol. 47

Pages: 354-359

ISSN: 01741551

Indexing

Scopus - 1 Citation

Other information

Authenticus ID: P-010-SCX

DOI: 10.1007/s00270-023-03636-2

Abstract (EN): Purpose: To analyze the effectiveness of type II endoleaks (T2E) embolization using intra-operative contrast-enhanced ultrasound (CEUS). Methods: Consecutive patients treated for T2E underwent a standardized protocol with trans-arterial or trans-lumbar access, large volume embolization, onlay fusion, and intra-operative CEUS. Technical success was defined by exclusion of endoleak by CEUS. Results: Twenty-six patients (mean age 81 ± 11 years old; 89% male) were treated. The mean aneurysm sac enlargement was 11 ± 8 mm from T2E diagnosis. Embolization was performed using Onyx® 18 in all patients with adjunctive coils in 13 patients (50%). After the first embolization, CEUS documented residual T2E in 13 patients (50%). Ten patients (38%) had additional embolization, which successfully eradicated the T2E in seven of them. Technical success was 50% after the first embolization attempt and 77% after additional attempts guided by CEUS (P = 0.080). There was no mortality. Median imaging follow-up was 22 months. Among the 20 patients with no residual T2E on completion CEUS, 16 (80%) had sac stabilization and none required additional interventions for T2E. Of the six patients with residual T2Es on CEUS, three had sac stabilization (50%) and one required additional reintervention for T2E. There was one late aortic rupture at 56 months. Conclusion: One in two patients treated by T2E embolization had residual endoleak on intra-operative CEUS after a first embolization attempt, decreasing to one in four patients after multiple attempts. A negative completion CEUS following embolization was associated with higher rates of sac stabilization and no need for additional T2E embolization. Graphical Abstract: (Figure presented.).

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5