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Transcatheter embolization of abdominal aortic endograft endoleaks using onyx and coils: mid-term imaging follow-up

Authors Ford CA, Lange BB, Morris CS

Received 7 November 2016

Accepted for publication 2 February 2017

Published 3 March 2017 Volume 2017:5 Pages 15—19

DOI https://doi.org/10.2147/JVD.S126926

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr Rahmi Oklu


Christopher A Ford, Benjamin B Lange, Christopher S Morris

Department of Radiology, University of Vermont Health Network, University of Vermont Medical Center, Burlington, VT, USA

Purpose: To evaluate the efficacy and safety of ethylene vinyl alcohol copolymer (Onyx) with or without coils in treatment of type II endoleaks associated with abdominal aortic endografts.
Materials and methods: The medical records of 14 patients (12 men and 2 women, mean age 73 years) with type II endoleaks associated with abdominal aortic endografts, and treated with Onyx, with or without coils, were reviewed. These patients underwent 19 type II endoleak embolization procedures. Time to follow up computed tomography angiogram (CTA), initial and follow-up aneurysm sac characteristics, embolization access technique, use of coils, volume and type of Onyx used, and complications were recorded.
Results: Mean procedure time was 124 minutes (range, 51–237 minutes), and mean volume of Onyx used per procedure was 2.1 cc (range, 1.5–3). Mean follow-up time between initial and final CTA was 19.9 months (range, 0.5–64.4). After one or more treatments, follow-up imaging documented complete occlusion of the endoleaks in 10 of 14 patients. Mean sac size decreased by an average of 0.3 cm in those with successful embolization and increased by an average of 0.4 cm in those with failed embolization. One major complication (infection, 5.2%) occurred before adding prophylactic antibiotics to our protocol. No significant inadvertent embolization occurred.
Conclusion: This study contributes to the growing body of data regarding safety and efficacy of treating type II endoleaks using Onyx. Potential benefits are both technical and economic. As we found advantages with the use of Onyx, additional studies are warranted.

Keywords: endoleak, onyx, embolization

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