Type II endoleak embolization after endovascular abdominal aortic aneurysm repair with use of real-time three-dimensional fluoroscopic needle guidance

Abstract

Current treatment for type II endoleak includes transarterial embolization and translumbar puncture, but each method has its drawbacks. With real-time three-dimensional fluoroscopy guidance, a cone-beam computed tomography (CT) image is created in which the needle trajectory is determined. The trajectory is superimposed on the fluoroscopy image, allowing real-time needle placement for precise embolization. We have used this method to treat five patients with complex type II endoleaks. All interventions were successful and uncomplicated. At 6-month follow-up, CT scan showed no recurrences. Direct puncture and injection with real-time three-dimensional fluoroscopy guidance shows encouraging results as treatment for complex type II endoleaks after endovascular abdominal aortic aneurysm repair (EVAR).