Key result
Preoperative embolization of aortic branch vessels associated with Type 2 endoleaks may decrease postoperative complications and the need for surveillance and reintervention following EVAR.
Preoperative imaging and prophylactic embolization of aortic branch vessels may reduce the incidence and complications of Type 2 endoleaks following EVAR.
May support preoperative embolization to reduce Type 2 endoleak complications after EVAR; leaves open need for randomized confirmation.
Type 2 endoleak (T2EL) is the most common complication following endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms. The management of T2ELs is controversial due to the relatively low incidence of negative outcomes when secondary intervention is avoided. Some studies challenge this practice as demonstrated by adverse events following conservative treatment of T2ELs. Evidence has shown that the preoperative computed tomographic angiogram can predict the development of T2EL based on a patient's arterial anatomy, specifically vessels associated with increased rates of post-EVAR endoleak development. Preoperative embolization of those aortic branch vessels associated with T2ELs has shown decreased rates of postoperative complications and may result in a decreased need for surveillance and reintervention.
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Lookstein et al. (2015) conducted a review in Abdominal aortic aneurysms and Type 2 endoleak following EVAR. Preoperative embolization of aortic branch vessels was evaluated. Preoperative embolization of aortic branch vessels associated with Type 2 endoleaks may decrease postoperative complications and the need for surveillance and reintervention following EVAR.
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