Percutaneous and Endovascular Embolization-Based Treatments of Type 1A and Type 1B Endoleaks after Endovascular Aneurysm Repair
Mustafa Mehmet Incesu, Mehmet Koray Akkan, Berrak Barutcu Asfuroglu, Umut Asfuroglu, Nesrin Erdogan Kaydu, Abdullah Ozer, Huseyin Demirtas, Gursel Levent Oktar, Erhan Turgut IlgitObjective
This retrospective, observational study was conducted to evaluate the efficacy of embolization-based treatments for Types 1A and 1B endoleaks following endovascular aneurysm repair.
Design
A total of 26 patients who underwent endovascular aneurysm repair between January 2005 and September 2023 and subsequently received embolization therapy for Types 1A or 1B endoleak, either at the end of the procedure or during follow-up, were retrospectively reviewed.
Methods
Embolization was performed in 16 patients with Type 1A endoleaks and 10 with Type 1B. Eight of the 16 patients who underwent embolization for Type 1A endoleaks required additional treatments such as aortic cuff placement or a chimney graft. Similarly, six out of the 10 patients treated with embolization for Type 1B endoleaks underwent adjunctive procedures such as iliac stent-graft extension. The primary endpoint was the absence of aneurysm sac enlargement. Secondary endpoints included technical success and the avoidance of endoleak-related reintervention.
Results
Aneurysm sac regression or stabilization was observed in 68.7% of Type 1A and 70% of Type 1B endoleak cases over mean follow-up periods of 43.1 and 22.3 months, respectively.
Conclusion
Embolization-based endovascular treatment, alone or combined with adjunctive endograft procedures, may achieve aneurysm sac stabilization or regression in a substantial proportion of patients with Types 1A and 1B endoleaks. However, the possibility of recurrence and reintervention, particularly in Type 1A endoleaks, remains an important limitation of this approach and warrants continued imaging surveillance.