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Embolization for Type Ia Endoleak after EVAR for Abdominal Aortic Aneurysms: A Systematic Review of the Literature

(1) Successful endovascular repair for abdominal aortic aneurysms is based on the complete exclusion of the aneurysm sac from the systemic circulation. Type Ia endoleak (ELIA) is defined as the persistent perfusion of the aneurysm sac due to incomplete proximal sealing between aorta and endograft, w...

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Autores principales: Marchiori, Elena, Ibrahim, Abdulhakim, Schäfers, Johannes Frederik, Oberhuber, Alexander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9220150/
https://www.ncbi.nlm.nih.gov/pubmed/35740463
http://dx.doi.org/10.3390/biomedicines10061442
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author Marchiori, Elena
Ibrahim, Abdulhakim
Schäfers, Johannes Frederik
Oberhuber, Alexander
author_facet Marchiori, Elena
Ibrahim, Abdulhakim
Schäfers, Johannes Frederik
Oberhuber, Alexander
author_sort Marchiori, Elena
collection PubMed
description (1) Successful endovascular repair for abdominal aortic aneurysms is based on the complete exclusion of the aneurysm sac from the systemic circulation. Type Ia endoleak (ELIA) is defined as the persistent perfusion of the aneurysm sac due to incomplete proximal sealing between aorta and endograft, with a consequent risk of rupture and death. Endoleak embolization has been sporadically reported as a viable treatment for ELIA. (2) A systematic literature search in PubMed of all publications in English about ELIA embolization was performed until February 2022. Research methods and reporting were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Data regarding patient numbers, technical success (endoleak absence at control angiography), reinterventions, clinical and imaging follow-up, and outcomes were collected and examined by two independent authors. (3) Twenty-one papers (12 original articles, 9 case reports) reported on 126 patients (age range 58–96 years) undergoing ELIA embolization 0–139 months after the index procedure. Indication for embolization was most often founded on unfavorable anatomy and patient comorbidities. Embolic agents used include liquid embolic agents, coils, plugs and combinations thereof. Technical success in this highly selected cohort ranged from 67–100%; the postprocedural complication rate within 30 days was 0–24%. ELIA recurrence was reported as 0–42.8%, with a secondary ELIA-embolization-intervention success rate of 50–100%. At a follow-up at 0–68 months, freedom from sac enlargement amounted to 76–100%, freedom from ELIA to 66.7–100%. (4) Specific literature about ELIA embolization is scant. ELIA embolization is a valuable bailout strategy for no-option patients; the immediate technical success rate is high and midterm and long-term outcomes are acceptable.
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spelling pubmed-92201502022-06-24 Embolization for Type Ia Endoleak after EVAR for Abdominal Aortic Aneurysms: A Systematic Review of the Literature Marchiori, Elena Ibrahim, Abdulhakim Schäfers, Johannes Frederik Oberhuber, Alexander Biomedicines Systematic Review (1) Successful endovascular repair for abdominal aortic aneurysms is based on the complete exclusion of the aneurysm sac from the systemic circulation. Type Ia endoleak (ELIA) is defined as the persistent perfusion of the aneurysm sac due to incomplete proximal sealing between aorta and endograft, with a consequent risk of rupture and death. Endoleak embolization has been sporadically reported as a viable treatment for ELIA. (2) A systematic literature search in PubMed of all publications in English about ELIA embolization was performed until February 2022. Research methods and reporting were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Data regarding patient numbers, technical success (endoleak absence at control angiography), reinterventions, clinical and imaging follow-up, and outcomes were collected and examined by two independent authors. (3) Twenty-one papers (12 original articles, 9 case reports) reported on 126 patients (age range 58–96 years) undergoing ELIA embolization 0–139 months after the index procedure. Indication for embolization was most often founded on unfavorable anatomy and patient comorbidities. Embolic agents used include liquid embolic agents, coils, plugs and combinations thereof. Technical success in this highly selected cohort ranged from 67–100%; the postprocedural complication rate within 30 days was 0–24%. ELIA recurrence was reported as 0–42.8%, with a secondary ELIA-embolization-intervention success rate of 50–100%. At a follow-up at 0–68 months, freedom from sac enlargement amounted to 76–100%, freedom from ELIA to 66.7–100%. (4) Specific literature about ELIA embolization is scant. ELIA embolization is a valuable bailout strategy for no-option patients; the immediate technical success rate is high and midterm and long-term outcomes are acceptable. MDPI 2022-06-18 /pmc/articles/PMC9220150/ /pubmed/35740463 http://dx.doi.org/10.3390/biomedicines10061442 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Marchiori, Elena
Ibrahim, Abdulhakim
Schäfers, Johannes Frederik
Oberhuber, Alexander
Embolization for Type Ia Endoleak after EVAR for Abdominal Aortic Aneurysms: A Systematic Review of the Literature
title Embolization for Type Ia Endoleak after EVAR for Abdominal Aortic Aneurysms: A Systematic Review of the Literature
title_full Embolization for Type Ia Endoleak after EVAR for Abdominal Aortic Aneurysms: A Systematic Review of the Literature
title_fullStr Embolization for Type Ia Endoleak after EVAR for Abdominal Aortic Aneurysms: A Systematic Review of the Literature
title_full_unstemmed Embolization for Type Ia Endoleak after EVAR for Abdominal Aortic Aneurysms: A Systematic Review of the Literature
title_short Embolization for Type Ia Endoleak after EVAR for Abdominal Aortic Aneurysms: A Systematic Review of the Literature
title_sort embolization for type ia endoleak after evar for abdominal aortic aneurysms: a systematic review of the literature
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9220150/
https://www.ncbi.nlm.nih.gov/pubmed/35740463
http://dx.doi.org/10.3390/biomedicines10061442
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