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CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2019; 03(03): S24
DOI: 10.1055/s-0041-1730586
Abstract

Outcomes of Type II Endoleak Treatment using High Volume Ethylene Vinyl Alcohol Copolymer (ONYX®)

Umar Tariq
Geisinger Medical Center, Danville, USA
,
Brandon Nuckles
Geisinger Medical Center, Danville, USA
,
Fatima Memon
Wayne State University/ Detroit Medical Center, Detroit, USA
,
Ravi Kagali
Wayne State University/ Detroit Medical Center, Detroit, USA
,
Vinod Maller
University of Tennessee Health Science Center, Memphis, USA
,
Tariq Rahman
Geisinger Medical Center, Danville, USA
,
Evan Ryer
Geisinger Medical Center, Danville, USA
,
Luis L. Nadal
Geisinger Medical Center, Danville, USA
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    Background: We aim to report our experience with Onyx®, (ethylene vinyl alcohol copolymer) for embolization of type 2 endoleak (T2E) after endovascular repair of abdominal aortic aneurysms (EVAR). Method(s): Endoleak repairs using Onyx performed from 2010 to 2016, as part of clinical management were retrospectively reviewed. Technical success (TS) was defined as absence of fluoroscopic evidence of endoleak at the termination of procedure. Clinical failure (CF) was defined as increase in sac diameter greater than 5 mm or increase in sac volume greater than 10% on follow-up computed tomography angiography (CTA), at least 3 months post-procedure or more. Absence of CF was deemed clinical success (CS). Student’s t-test was used for statistical analysis. A p value of less than 0.05 was defined to be statistically significant. Result(s): A total of 13 patients (mean age 77 years, 12 males and 1 female) underwent persistent T2E repair following EVAR at our institution in a duration of 6 years. Mean interval between EVAR and endoleak repair was 40.7 months. Translumbar access was used in all patients. The mean volume of Onyx used per treatment was 13.4 mL. Additional targeted coil embolization of a feeding inferior mesenteric artery was performed in one patient. TS and CS was achieved in all patients; none of the patients had CF. Mean pre-treatment diameter and volume were 73 mm and 340 cc respectively. Mean post-treatment diameter and volume were 71 mm and 320 cc respectively. There was a trend towards decreased diameter and improved volume post-treatment, however it did not reach statistical significance (p = 0.11). There were no major postprocedural complications. Conclusion(s): Our study presents the clinical outcome of the use of Onyx as the main treatment modality on patients with T2E after EVAR. Onyx with or without coils is safe and effective in treatment of T2E after EVAR.


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    Address for correspondence

    Umar Tariq
    Geisinger Medical Center, Danville
    USA   

    Publication History

    Article published online:
    11 May 2021

    © 2019. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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