Preoperative Embolization for the Prevention of Type II Endoleak

Abstract

Type II endoleak (EL2) is the most common graft-related complication after endovascular abdominal aortic aneurysm repair (EVAR), and is associated with aneurysmal enlargement, re-intervention and even rupture. Patent aortic side branches, i.e., the inferior mesenteric artery (IMA) or the lumbar artery (LA) are thought to be the independent risk factor for EL2. Some researchers proposed preoperative embolization for the prevention of EL2 such as aortic side branch embolization or sac embolization. However, the efficacy of these preventive methods is controversial because there has been little evidence to support it. Therefore, we have been starting prospective multi-center clinical trials of preoperative IMA and LA embolization. In this article, we reviewed previous research regarding preoperative embolization for EL2, and also outlined the early stages of our clinical trials.