Vascular plug in the treatment of high-flow type I endoleak after endovascular repair of abdominal aortic aneurysm

BACKGROUND: The aim of this study was to evaluate the feasibility, safety, and radiographic outcomes of vascular plug embolization for high-flow type I endoleaks after endovascular repair of abdominal aortic aneurysms. METHODS: This single-center retrospective case series included 10 patients who underwent endovascular repair of abdominal aortic aneurysms. These patients were subsequently diagnosed with high-flow type I endoleaks, either during the index endovascular repair of abdominal aortic aneurysms at completion angiography or during a staged procedure prompted by the evidence of a persistent type I endoleak on follow-up contrast-enhanced computed tomography. Each patient received endovascular embolization using vascular plugs. The collected data comprised patient demographics, clinical characteristics, complications, device number and size, and procedural details. Contrast-enhanced computed tomography was scheduled at 1, 3, 6, and 12 months and annually thereafter for up to 5 years. RESULTS: Seven patients (70.0%) had type Ia endoleaks and three (30.0%) had type Ib endoleaks. Twelve vascular plugs were implanted with 100% technical success and complete occlusion of all type I endoleaks. Imaging follow-up was available in eight patients; during 6-52 months of observation, no recurrent type I endoleak was detected on contrast-enhanced computed tomography. CONCLUSIONS: Vascular plug embolization of high-flow type I endoleaks after endovascular repair of abdominal aortic aneurysm is feasible and safe. The technical success rate is high with durable radiographic exclusion on early to mid-term follow-up.