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Unenhanced Cone Beam Computed Tomography and Fusion Imaging in Direct Percutaneous Sac Injection for Treatment of Type II Endoleak: Technical Note

  • Technical Note
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

An Erratum to this article was published on 09 November 2015

Abstract

Aim

To evaluate safety, feasibility, technical success, and clinical success of direct percutaneous sac injection (DPSI) for the treatment of type II endoleaks (T2EL) using anatomical landmarks on cone beam computed tomography (CBCT) and fusion imaging (FI).

Materials and Methods

Eight patients with T2EL were treated with DPSI using CBCT as imaging guidance. Anatomical landmarks on unenhanced CBCT were used for referencing T2EL location in the first five patients, while FI between unenhanced CBCT and pre-procedural computed tomography angiography (CTA) was used in the remaining three patients. Embolization was performed with thrombin, glue, and ethylene–vinyl alcohol copolymer. Technical and clinical success, iodinated contrast utilization, procedural time, fluoroscopy time, and mean radiation dose were registered.

Results

DPSI was technically successful in all patients: the needle was correctly positioned at the first attempt in six patients, while in two of the first five patients the needle was repositioned once. Neither minor nor major complications were registered. Average procedural time was 45 min and the average administered iodinated contrast was 13 ml. Mean radiation dose of the procedure was 60.43 Gy cm2 and mean fluoroscopy time was 18 min. Clinical success was achieved in all patients (mean follow-up of 36 months): no sign of T2EL was reported in seven patients until last CT follow-up, while it persisted in one patient with stability of sac diameter.

Conclusions

DPSI using unenhanced CBCT and FI is feasible and provides the interventional radiologist with an accurate and safe alternative to endovascular treatment with limited iodinated contrast utilization.

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Authors and Affiliations

  1. Interventional Radiology, Department of Radiology, Insubria University, Viale Borri, 57, 21100, Varese, VA, Italy

    Gianpaolo Carrafiello, Anna Maria Ierardi, Giuseppe De Marchi, Chiara Floridi & Fontana Federico

  2. Philips Healthcare, Best, The Netherlands

    Alessandro Radaelli

  3. Vascular Surgery Department, University of Insubria, Viale Borri, 57, 21100, Varese, VA, Italy

    Gabriele Piffaretti

Authors
  1. Gianpaolo Carrafiello
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  2. Anna Maria Ierardi
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  3. Alessandro Radaelli
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  4. Giuseppe De Marchi
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  5. Chiara Floridi
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  6. Gabriele Piffaretti
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  7. Fontana Federico
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Corresponding author

Correspondence to Gianpaolo Carrafiello.

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Conflict of interest

Alessandro Radaelli declares to have conflict of interest; the remaining authors declare to have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.

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Carrafiello, G., Ierardi, A.M., Radaelli, A. et al. Unenhanced Cone Beam Computed Tomography and Fusion Imaging in Direct Percutaneous Sac Injection for Treatment of Type II Endoleak: Technical Note. Cardiovasc Intervent Radiol 39, 447–452 (2016). https://doi.org/10.1007/s00270-015-1217-x

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  • DOI: https://doi.org/10.1007/s00270-015-1217-x

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