Ethylene-vinyl alcohol copolymer as embolic agent for treatment of type II endoleak: our experience

Radiol Med. 2017 Feb;122(2):154-159. doi: 10.1007/s11547-016-0703-9. Epub 2016 Nov 5.

Abstract

Aim: To evaluate safety, technical and clinical success of embolization of type II endoleak (T2 EL) using ethylene-vinyl alcohol copolymer as embolic agent alone or in combination with others materials.

Materials and methods: From March 2007 to March 2015, 104 patients presented T2 EL during follow-up. A total of 21 patients met the criteria for treatment. T2 EL was treated with TAE (n = 18), DPSI (n = 10) or laparoscopic ligature of the inferior mesenteric artery (n = 1). DPSI was considered in case TAE was unsuccessful (8/18 patients). Ethylene-vinyl alcohol copolymer was used as embolic agent in 12 patients: alone in 5 cases, in association with glue and with glue and thrombin in 3 and 2 cases, respectively, during TAE. Onyx was injected in two cases of embolization performed with DPSI: in one case alone and in the other in combination with thrombin and glue.

Results: Technical success rate was 100%. Immediate clinical success was 91.7%; in one patient CEUS revealed persistent T2 EL, decreased if compared with that before the procedure. Secondary clinical success was 91.7%; until today, in one patient T2EL is persistent, nevertheless, the sac diameter remained stable. No major or minor complications were registered.

Conclusions: Onyx could be an ideal embolic agent for endovascular and percutaneous embolization of T2 EL.

Keywords: Embolization; Ethylene-vinyl alcohol copolymer; Onyx; Type II endoleak.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Embolization, Therapeutic* / methods
  • Endoleak / diagnostic imaging
  • Endoleak / therapy*
  • Endovascular Procedures / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mesenteric Artery, Inferior
  • Middle Aged
  • Polyvinyls / administration & dosage*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Polyvinyls
  • ethylene-vinyl alcohol copolymer