Ethylene-vinyl alcohol copolymer as embolic agent for treatment of type II endoleak: our experience

AIM: To evaluate safety, technical and clinical success of embolization of type II endoleak (T2 EL) using ethylene-vinyl alcohol copolymer as embolic agent alone or in combination with others materials. MATERIALS AND METHODS: From March 2007 to March 2015, 104 patients presented T2 EL during follow-up. A total of 21 patients met the criteria for treatment. T2 EL was treated with TAE (n = 18), DPSI (n = 10) or laparoscopic ligature of the inferior mesenteric artery (n = 1). DPSI was considered in case TAE was unsuccessful (8/18 patients). Ethylene-vinyl alcohol copolymer was used as embolic agent in 12 patients: alone in 5 cases, in association with glue and with glue and thrombin in 3 and 2 cases, respectively, during TAE. Onyx was injected in two cases of embolization performed with DPSI: in one case alone and in the other in combination with thrombin and glue. RESULTS: Technical success rate was 100%. Immediate clinical success was 91.7%; in one patient CEUS revealed persistent T2 EL, decreased if compared with that before the procedure. Secondary clinical success was 91.7%; until today, in one patient T2EL is persistent, nevertheless, the sac diameter remained stable. No major or minor complications were registered. CONCLUSIONS: Onyx could be an ideal embolic agent for endovascular and percutaneous embolization of T2 EL.