Aortic side branch embolization before endovascular aneurysm repair: Incidence of type II endoleak

PURPOSE: To assess the feasibility of embolization of aortic side branches and its impact on the incidence of type II endoleak after endovascular aneu rysm repair. MATERIALS AND METHODS: Endovascular aneurysm repair was performed in 74 pat ients. Aortic side branch Vessels were evaluated on the preoperative angiog ram and computed tomography (CT) and, where embolization of lumbar and infe rior mesenteric vessels was considered technically possible, this was attem pted prior to endovascular repair. Follow-up CT was used to assess the pres ence of type II endoleak. RESULTS: Seventy-two patients were followed up for longer than 1 month. Emb olization was attempted in 25 cases, successfully in 10, with partial succe ss in 11, and failure in four. Twenty patients with successful or partly su ccessful preoperative embolization were discharged and followed-up. Four (2 0%) had demonstrable type II endoleak during follow-up, with two of these p ersisting at latest follow-up. Of 43 patients without previous embolization , there were 10 (23.3%) type II endoleaks during the follow-up period, four of these persisting. In cases with type II endoleak, mean sac diameter cha nge was -0.5 mm in the cases with previous embolization and +3.1 mm without . The mean period to onset of type II endoleak was 6.9 months without, and 15.3 months with, previous embolization. CONCLUSION: Although the cohort size is below a level that would confer sig nificance, the trend of these findings is such as to suggest a lack of infl uence of aortic side branch embolization on the incidence of type II endole ak during the follow-up period.