Preoperative Coil Embolization to Aortic Branched Vessels for Prevention of Aneurysmal Sac Enlargement Following EVAR: Early Clinical Result

Ann Vasc Dis. 2013;6(2):175-9. doi: 10.3400/avd.oa.12.00079. Epub 2013 May 10.

Abstract

Objective: Persistent Type 2 endoleaks (PT2) after endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) are associated with increased adverse outcomes, including aneurysmal sac enlargement and rupture. The aim of this study was to report early clinical outcomes of coil embolization (CE) to aortic branched vessels prior to EVAR and assess the effectiveness of this strategy in terms of prevention of sac growth due to PT2.

Materials and methods: Between May 2007 and April 2012, EVAR was performed for 215 cases, divided into two groups (150 cases in Group A, before introduction of CE; 21 in Group B, receiving CE before EVAR). Early clinical outcomes were compared between groups.

Results: Fifty percent of cases in Group B had a marked reduction of aneurysmal sac diameter based on multi-detector row computed tomographic angiography (MDCTA) findings at the 6-month follow-up after EVAR, whereas, only 25% of cases in Group A had shrinkage of the aneurysmal sac during the same time period after EVAR.

Conclusion: This strategy has the possibility of improving late outcomes of EVAR by reducing endoleak volumes beforehand.

Keywords: EVAR; coil embolization; endoleaks.