A Narrative Review of Preemptive Aortic Side Branch Embolization in Preventing Type II Endoleak after Endovascular Abdominal Aneurysm Repair

Abstract

Preemptive side branch embolization may help prevent type II endoleak, reduce reintervention rates, and promote early aneurysm sac shrinkage after endovascular aneurysm repair. However, evidence of its effectiveness in preventing aneurysm rupture, reducing aneurysm-related mortality, ensuring safety, and maintaining cost-effectiveness is limited. The 2024 European Society for Vascular Surgery guidelines do not recommend routine preemptive embolization due to a lack of high-quality evidence. Concerns about radiation exposure and financial costs remain unresolved. Further research is needed to identify patients who would benefit most from preemptive embolization, as well as to evaluate its long-term impact on clinical outcomes, safety, and cost-effectiveness.