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Endoleak after endovascular graft repair of experimental aortic aneurysms: Does coil embolization with angiographic “seal” lower intraaneurysmal pressure? 

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Presentation on theme: "Endoleak after endovascular graft repair of experimental aortic aneurysms: Does coil embolization with angiographic “seal” lower intraaneurysmal pressure? "— Presentation transcript:

1 Endoleak after endovascular graft repair of experimental aortic aneurysms: Does coil embolization with angiographic “seal” lower intraaneurysmal pressure?  Bettina Marty, MD, Luis A. Sanchez, MD, Takao Ohki, MD, Reese A. Wain, MD, Peter L. Faries, MD, Jacob Cynamon, MD, Michael L. Marin, MD, Frank J. Veith, MD  Journal of Vascular Surgery  Volume 27, Issue 3, Pages (March 1998) DOI: /S (98) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

2 Fig. 1 Various types of models used in this study. a, Group I, untreated PTFE aneurysms. b, Group II, aneurysms managed with EVG without endoleak. c, Group III, aneurysms managed with EVG with endoleak. These EVGs had a 4 mm diameter hole in the graft to produce the endoleak. d, Same models as in c after the endoleak was packed with coils. A, Aneurysm; T, pressure transducer; EVG, endovascular graft; pS, proximal stent; dS, distal stent; G, graft; EL, endoleak; C, coils. Journal of Vascular Surgery  , DOI: ( /S (98) ) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

3 Fig. 2 Macroscopic view of an endoleak 2 weeks after implantation (group III) and corresponding CT scan. A, Autopsy specimen demonstrates an aneurysm filled with thrombus except for a liquid-filled cavity associated to a 4 mm hole in the endovascular graft. B, Contrast-enhanced CT scan. EL, Endoleak; EVG, endovascular graft; A, aneurysm; T, pressure transducer. Journal of Vascular Surgery  , DOI: ( /S (98) ) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

4 Fig. 3 IAP ratio measurements. Mean values for systolic IAP ratio in group III decreased on the first postoperative day and reincreased and stabilized at a high level. IAP ratios remained high for untreated aneurysms (group I) and low for dogs in which aneurysm had been excluded by an EVG without an endoleak (group II). At day 30 *p = 0.025, **p = , #p = Journal of Vascular Surgery  , DOI: ( /S (98) ) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

5 Fig. 4 Mean values for systolic IAP ratio before and after coil embolization of the endoleaks in group III. Immediately after embolization IAP ratio increased, possibly because of thrombus destruction after placement of the coils. Coil embolization failed to decrease IAP ratio during a 1-month period. Journal of Vascular Surgery  , DOI: ( /S (98) ) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

6 Fig. 5 Arteriogram (A), contrast CT scan (B) and color duplex scan (C) demonstrate endoleak. Graft hole is marked with radiopaque wire (arrow) in A. EL, Endoleak; T, pressure transducer; A, aneurysm; EVG, endovascular graft. Journal of Vascular Surgery  , DOI: ( /S (98) ) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

7 Fig. 6 There was no correlation between the maximal diameter of endoleaks and mean systolic IAP ratio. Journal of Vascular Surgery  , DOI: ( /S (98) ) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

8 Fig. 7 Arteriogram (A), contrast CT scan (B), and color duplex scan (C) of endoleaks after coil embolization. Arteriogram and CT scan demonstrate sealing of the endoleaks after coil embolization and no contrast material outside the EVG (star). There was no flow around the coils on color duplex scans, although this finding does not show on this image. C, coils; T, pressure transducer; EVG, endovascular graft. Journal of Vascular Surgery  , DOI: ( /S (98) ) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

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