Barleben A et al. – This study evaluated the safety, efficacy, and durability of perigraft arterial sac embolization (PASE) in patients treated for endoleaks (ELs) diagnosed at the time of endovascular aneurysm repair (EVAR). In this study, PASE was demonstrated as an effective tool in sac management in combination with EVAR by stabilizing sac size and eliminating low and certain high–pressure ELs. The safety and durability was evidenced by patients who were stable out to 12 years. However, to evaluate the morbidity and mortality benefit of this improvement in EVAR, further studies are required.

Methods

• Data were collected from databases of 2 institutions between 2008 and 2016 and were reviewed retrospectively.
• Cessation of aneurysm growth on computed tomography scan was the primary efficacy end point.
• Nontarget embolization and clinical sequelae were the primary safety end points.

Results

• A total of 50 patients treated with PASE were included in the study. Type I and type II ELs were treated in 33% and 59% of patients, respectively.
• The aneurysms of all patients stopped their growth after PASE, while 74% demonstrated sac regression when treated for type II ELs.
• There were no reports of nontarget embolization, spinal ischemia, allergic reaction, rupture, or obvious colonic ischemia in the study.
• After PASE the number of type I and type II ELs decreased from 22 to 3 (86% success) and 39 to 11 (72% success), respectively.
• A total of 26 patients (89%) showed sac regression, and the remaining 3 patients showed stable sac size when PASE was used at the time of EVAR.
• No evidence of recanalization after thrombosis of culprit vessel for ELs was reported.