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CardioVascular and Interventional Radiology

, Volume 38, Issue 3, pp 507–522 | Cite as

Type 2 Endoleaks Post-EVAR: Current Evidence for Rupture Risk, Intervention and Outcomes of Treatment

  • Raymond ChungEmail author
  • Robert A. Morgan
Review/State of the Art

Abstract

Type 2 endoleaks (EL2) are the most commonly encountered endoleaks following EVAR. Despite two decades of experience, there remains considerable variation in the management of EL2 with controversies ranging from if to treat, when to treat and how to treat. Here, we summarise the available evidence, describe the treatment techniques available and offer guidelines for management.

Keywords

Type 2 endoleak EVAR Embolisation Direct sac puncture 

Notes

Conflict of interest

Raymond Chung—no conflict of interest. Robert Morgan—Proctor for Covidien. Outside the submitted work. No relevant conflicts of interest.

References

  1. 1.
    Timaran CH, Ohki T, Rhee SJ, Veith FJ, Gargiulo NJ, Toriumi H, Malas MB, Suggs WD, Wain RA, Lipsitz EC (2004) Predicting aneurysm enlargement in patients with persistent type II endoleaks. J Vasc Surg 39:1157–1162CrossRefPubMedGoogle Scholar
  2. 2.
    Nevala T, Biancari F, Manninen H, Aho PS, Matsi P, Mäkinen K, Roth WD, Ylönen K, Lepäntalo M, Perälä J (2010) Type II endoleak after endovascular repair of abdominal aortic aneurysm: effectiveness of embolization. Cardiovasc Interv Radiol 33(2):278–284CrossRefGoogle Scholar
  3. 3.
    Warrier R, Miller R, Bond R, Robertson IK, Hewitt P, Scott A (2008) Risk factors for type II endoleaks after endovascular repair of abdominal aortic aneurysms. ANZ J Surg 78(1–2):61–63CrossRefPubMedGoogle Scholar
  4. 4.
    Baum RA, Carpenter JP, Tuite CM, Velazquez OC, Soulen MC, Barker CF, Golden MA, Pyeron AM, Fairman RM (2000) Diagnosis and treatment of inferior mesenteric arterial endoleaks after endovascular repair of abdominal aortic aneurysms. Radiology 215:409–413CrossRefPubMedGoogle Scholar
  5. 5.
    Rhee SJ, Ohki T, Veith FJ, Kurvers H (2003) Current status of management of type II endoleaks after endovascular repair of abdominal aortic aneurysms. Ann Vasc Surg 17:335–344CrossRefPubMedGoogle Scholar
  6. 6.
    Jones JE, Atkins MD, Brewster DC, Chung TK, Kwolek CJ, LaMuraglia GM, Hodgman TM, Cumbria RP (2007) Persistent type 2 endoleak after endovascular repair of abdominal aortic aneurysm is associated with adverse late outcomes. J Vasc Surg 46:1–8CrossRefPubMedGoogle Scholar
  7. 7.
    Arko FR, Rubin GD, Johnson BL, Hill BB, Fogarty TJ, Zarins CK (2001) Type-II endoleaks following endovascular AAA repair: preoperative predictors and long-term effects. J Endovasc Ther 8:503–510CrossRefPubMedGoogle Scholar
  8. 8.
    Marrewijk CV, Fransen G, Laheij RJF, Harris PL, Buth J (2004) EUROSTAR collaborators. Is a type II endoleak after EVAR a harbinger of risk? Causes and outcome of open conversion and aneurysm rupture during follow-up. Eur J Vasc Endovasc Surg 27:128–137CrossRefPubMedGoogle Scholar
  9. 9.
    El Batti S, Cochennec F, Roudot-Thoraval F, Becquemin JP (2013) Type II endoleaks after endovascular repair of abdominal aortic aneurysm are not always a benign condition. J Vasc Surg 57:1291–1298CrossRefPubMedGoogle Scholar
  10. 10.
    Sadek M, Dexter DJ, Rockman CB, Hoang H, Mussa FF, Cayne NS, Jacobowitz GR, Veith FJ, Adelman MA, Maldonado TS (2013) Preoperative relative abdominal aortic aneurysm thrombus burden predicts endoleak and sac enlargement after endovascular aneurysm repair. Ann Vasc Surg 27(8):1036–1041CrossRefPubMedGoogle Scholar
  11. 11.
    Wild JB, Dattani N, Stather P, Bown MJ, Sayers RD, Choke E (2013) Effect of anticoagulation and antiplatelet therapy on incidence of endoleaks and sac size expansions after endovascular aneurysm repair. Ann Vasc Surg 28(3):554–559CrossRefPubMedGoogle Scholar
  12. 12.
    Fairman RM, Carpenter JP, Baum RA, Larson RA, Golden MA, Barker CF, Mitchell ME, Velazguez OC (2002) Potential impact of therapeutic warfarin treatment on type II endoleaks and sac shrinkage rates on midterm follow-up examination. J Vasc Surg 35(4):679–685CrossRefPubMedGoogle Scholar
  13. 13.
    Muthu C, Maani J, Plank LD, Holden A, Hill A (2007) Strategies to reduce the rate of type II endoleaks: routine intraoperative embolization of the inferior mesenteric artery and thrombin injection into the aneurysm sac. J Endovasc Ther 14:661–668CrossRefPubMedGoogle Scholar
  14. 14.
    Gould DA, McWilliams RG, Edwards RD et al (2001) Aortic side branch embolization before endovascular aneurysm repair: incidence of type II endoleak. J Vasc Interv Radiol 15:337–341CrossRefGoogle Scholar
  15. 15.
    Bonvini R, Alerci M, Antonucci F, Tutta P, Wyttenbach R, Bogen M, Pelloni A, von Segesser L, Gallino A (2003) Preoperative embolization of collateral side branches: a valid means to reduce type II endoleaks after endovascular AAA repair. J Endovasc Ther 10:227–232CrossRefPubMedGoogle Scholar
  16. 16.
    Ronsivalle S, Faresin F, Franz F, Rettore C, Zanchetta M, Olivieri A (2010) Aneurysm sac “thrombization” and stabilization in EVAR: a technique to reduce the risk of type II endoleak. J Endovasc Ther 17:517–524CrossRefPubMedGoogle Scholar
  17. 17.
    Sheehan MK, Hagino RT, Canby E, Wholey MH, Postoak D, Suri R, Toursarkissian B (2006) Type 2 endoleaks after abdominal aortic aneurysm stent grafting with systematic mesenteric and lumbar coil embolization. Ann Vasc Surg 20(4):458–463CrossRefPubMedGoogle Scholar
  18. 18.
    Ward TJ, Cohen S, Fischman AM, Kim E, Nowakowski FS, Ellozy SH, Faries PL, Marin ML, Lookstein RA (2013) Preoperative inferior mesenteric artery embolization before endovascular aneurysm repair: decreased incidence of type II endoleak and aneurysm sac enlargement with 24-month follow-up. J Vasc Interv Radiol 24(1):49–55CrossRefPubMedGoogle Scholar
  19. 19.
    Alerci M, Giamboni A, Wyttenbach R, Porretta AP, Antonucci F, Bogen M, Toderi M, Guerra A, Sartori F, Tutta P, Inglese L, Limoni C, Gallino A, Segesser LKV (2013) Endovascular abdominal aneurysm repair and impact of systematic preoperative embolization of collateral arteries: endoleak analysis and long-term follow-up. J Endovasc Ther 20:663–671CrossRefPubMedGoogle Scholar
  20. 20.
    Gelfand DV, White GH, Wilson SE (2006) Clinical significance of type II endoleak after endovascular repair of abdominal aortic aneurysm. Ann Vasc Surg 20(1):69–74CrossRefPubMedGoogle Scholar
  21. 21.
    Parent FN, Meier GH, Godziachvili V, LeSar CJ, Parker FM, Carter KA, Gayle RG, DeMasi RJ, Marcinczyk MJ, Gregory RT (2002) The incidence and natural history of type I and II endoleak: a 5-year follow-up assessment with color duplex ultrasound scan. J Vasc Surg 35:474–481CrossRefPubMedGoogle Scholar
  22. 22.
    Marchiori A, Ristow AV, Guimaraes M, Schonholz C, Uflacker R (2011) Predictive factors for the development of type II endoleaks. J Endovasc Ther 18:299–305CrossRefPubMedGoogle Scholar
  23. 23.
    Marrewijk CV, Buth J, Harris PL, Norgren L, Nevelsteen A, Wyatt MG (2002) Significance of endoleaks after endovascular repair of abdominal aortic aneurysms: the EUROSTAR experience. J Vasc Surg 35:461–473CrossRefPubMedGoogle Scholar
  24. 24.
    Ferrari M, Sardella SG, Berchiolli R, Adami D, Vignali C, Napoli V, Serino F (2005) Surgical treatment of persistent type 2 endoleaks, with increase of the aneurysm sac: indications and technical notes. Eur J Vasc Endovasc Surg 29:43–46CrossRefPubMedGoogle Scholar
  25. 25.
    Greenhalgh RM (2010) The United Kingdom EVAR trial investigators. Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med 362:1863–1871CrossRefPubMedGoogle Scholar
  26. 26.
    Wyss TR, Brown LC, Powell JT, Greenhalgh RM (2010) Rate and predictability of graft rupture after endovascular and open aortic aneurysm repair: data from the EVAR trials. Ann Surg 252:805–812CrossRefPubMedGoogle Scholar
  27. 27.
    Sidloff DA, Stather PW, Choke E, Bown MJ, Sayers RD (2013) Type II endoleak after endovascular aneurysm repair. Br J Surg 100(10):1262–1270CrossRefPubMedGoogle Scholar
  28. 28.
    Nolz R, Teufelsbauer H, Asenbaum U, Bietzke D, Funovics M, Wibner A, Plank C, Prusa AM, Lammer J, Schoder M (2012) Type II endoleaks after endovascular repair of abdominal aortic aneurysms: fate of the aneurysm sac and neck changes during follow-up. J Endovasc Ther 19:193–199CrossRefPubMedGoogle Scholar
  29. 29.
    Wilmot A, Stavropoulous SW (2007) Embolization of a recurrent type 2 endoleak using the liquid embolic n-butyl cyanoacrylate. Semin Interv Radiol 24:38–42CrossRefGoogle Scholar
  30. 30.
    Barbiero G, Baratto A, Ferro F, Dall’Acqua J, Fittà C, Miotto D (2008) Strategies of endoleak management following endoluminal treatment of abdominal aortic aneurysms in 95 patients: how, when and why. Radiol Med 113(7):1029–1042CrossRefPubMedGoogle Scholar
  31. 31.
    Buth J, Harris PL, Van Marrewijk C, Fransen G (2003) Endoleaks during follow-up after endovascular repair of abdominal aortic aneurysm. Are they all dangerous? J Cardiovasc Surg 44(4):559–566Google Scholar
  32. 32.
    Mandziak DM, Stanley BM, Foreman RK, Walsh JA, Burnett JR (2004) Outcome of endoleak following endoluminal abdominal aortic aneurysm repair. ANZ J Surg 74(12):1039–1042CrossRefPubMedGoogle Scholar
  33. 33.
    Rayt HS, Sandford RM, Salem M, Bown MJ, London NJ, Sayers RD (2009) Conservative management of type 2 endoleaks is not associated with increased risk of aneurysm rupture. Eur J Vasc Endovasc Surg 38:718–723CrossRefPubMedGoogle Scholar
  34. 34.
    Baum RA, Carpenter JP, Cope C, Golden MA, Velazquez OC, Neschis DG et al (2001) Aneurysm sac pressure measurements after endovascular repair of abdominal aortic aneurysms. J Vasc Surg 33:32–41CrossRefPubMedGoogle Scholar
  35. 35.
    Görich J, Rilinger N, Sokiranski R, Krämer S, Schütz A, Sunder-Plassmann L, Pamler R (2000) Embolization of type II endoleaks fed by the inferior mesenteric artery: using the superior mesenteric artery approach. J Endovasc Ther 7:297–301CrossRefPubMedGoogle Scholar
  36. 36.
    Schurink GW, Aarts NJ, Wilde J, van Baalen JM, Chuter TA, Schultze Kohl LJ et al (1998) Endoleakage after stent-graft treatment of abdominal aneurysm. Implications on pressure and imaging-an in vitro study. J Vasc Surg 28:234–241CrossRefPubMedGoogle Scholar
  37. 37.
    Li Z, Kleinsteuer C (2006) Computational analysis of type II endoleaks in a stented abdominal aortic aneurysm model. J Biomech 39:2573–2582CrossRefPubMedGoogle Scholar
  38. 38.
    Knowles M, Pellisar T, Murphy EH, Stanely GA, Hashmi AF, Arko Z, Arko FR III (2011) In vitro analysis of type II endoleaks and aneurysm sac pressurization on longitudinal stent-graft displacement. J Endovasc Ther 18:601–606CrossRefPubMedGoogle Scholar
  39. 39.
    Karthikesalingam A, Thrumurthy SGH, Jackson D, Sayers RD, Loftus IM, Thompson MM, Holt PJ (2012) Current evidence is insufficient to define an optimal threshold for intervention in isolated type II endoleak after endovascular aneurysm repair. J Endovasc Ther 19(2):200–208CrossRefPubMedGoogle Scholar
  40. 40.
    Lawrence-Brown MM, Sun Z, Semmens JB, Liffman K, Šutalo ID, Hartley DB (2009) Type II endoleaks: when is Intervention Indicated and What Is the Index of Suspicion for Types I or III? J Endovasc Ther 16(Suppl 1):106–118Google Scholar
  41. 41.
    Steinmetz E, Rubin BG, Sanchez LA, Choi ET, Geraghty PJ, Baty J, Thompson RW, Flye MW, Hovsepian DM, Picus D, Sicard GA (2004) Type II endoleak after endovascular abdominal aortic aneurysm repair: a conservative approach with selective intervention is safe and cost-effective. J Vasc Surg 39:306–313CrossRefPubMedGoogle Scholar
  42. 42.
    Buth J, Harris PL, van Marrewijk C, Fransen G (2003) The significance and management of different types of endoleaks. Semin Vasc Surg 16(2):95–102CrossRefPubMedGoogle Scholar
  43. 43.
    Abularrage CJ, Patel VI, Conrad MF, Schneider EB, Cambria RP, Kwolek CJ (2012) Improved results using Onyx glue for the treatment of persistent type 2 endoleak after endovascular aneurysm repair. J Vasc Surg 56:630–636CrossRefPubMedGoogle Scholar
  44. 44.
    Stavropoulos SW, Kim H, Clark TW, Fairman RM, Belazquez O, Carpenter JP (2005) Embolization of type 2 endoleaks after endovascular repair of abdominal aortic aneurysms with use of cyanoacrylate with or without coils. J Vasc Interv Radiol 16(6):857–861CrossRefPubMedGoogle Scholar
  45. 45.
    Boks SS, Andhyiswara T, de Smet AA, Vroegindeweij D (2005) Ultrasound-guided percutaneous transabdominal treatment of a type 2 endoleak. Cardiovasc Interv Radiol 28(4):526–529CrossRefGoogle Scholar
  46. 46.
    Martin ML, Dolmatch BL, Fry PD, Machan LS (2001) Treatment of type II endoleaks with Onyx. J Vasc Interv Radiol 12(5):629–632CrossRefPubMedGoogle Scholar
  47. 47.
    Schmid R, Gurke L, Aschwanden M, Stierli P, Jacob AL (2002) CT-guided percutaneous embolization of a lumbar artery maintaining a type II endoleak. J Endovasc Ther 9:198–202PubMedGoogle Scholar
  48. 48.
    Scali ST, Vlada A, Chang CK, Beck AW (2013) Transcaval embolization as an alternative technique for the treatment of type II endoleak after endovascular aortic aneurysm repair. J Vasc Surg 57:869–874CrossRefPubMedCentralPubMedGoogle Scholar
  49. 49.
    van Bindsbergen L, Braak SJ, van Strijen MJ, de Vries JP (2010) Type II endoleak embolization after endovascular abdominal aortic aneurysm repair with use of real-time three-dimensional fluoroscopic needle guidance. J Vasc Interv Radiol 21(9):1443–1447CrossRefPubMedGoogle Scholar
  50. 50.
    Katada Y, Kondo S, Takahashi S, Okita Y, Kagoshima A, Rokkaku K, Nozaki M (2013) Direct percutaneous puncture embolization of type II endoleaks using a coaxial technique. J Endovasc Ther 20(1):34–38CrossRefPubMedGoogle Scholar
  51. 51.
    Massis K, Carson WG III, Rozas A, Patel V, Zwiebel B (2012) Treatment of type II endoleaks with ethylene-vinyl-alcohol copolymer (Onyx). Vasc Endovasc Surg 46(3):251–257CrossRefGoogle Scholar
  52. 52.
    Coppi G, Saitta G, Coppi G, Gennai S, Lauricella A, Silingardi R (2014) Transealing: a novel and simple technique for embolization of type 2 endoleaks through direct sac access from the distal stent-graft landing zone. Eur J Vasc Endovasc Surg 47(4):394–401CrossRefPubMedGoogle Scholar
  53. 53.
    Quinones-Baldrich W, Levin ES, Lew W, Barleben A (2014) Intraprocedural and postprocedural perigraft arterial sac embolization (PASE) for endoleak treatment. J Vasc Surg 59(2):538–541CrossRefPubMedGoogle Scholar
  54. 54.
    Faries PL, Cadot H, Agarwal G, Kent KC, Hollier LH, Marin ML (2003) Management of endoleak after endovascular aneurysm repair: cuffs, coils, and conversion. J Vasc Surg 37:1155–1161CrossRefPubMedGoogle Scholar
  55. 55.
    Haulon S, Tyazi A, Willoteaux S, Koussa M, Lions C, Beregi JP (2001) Embolization of type II endoleaks after aortic stent-graft implantation: technique and immediate results. J Vasc Surg 34:600–605CrossRefPubMedGoogle Scholar
  56. 56.
    Bosiers MJ, Schwindt A, Donas KP, Torsello G (2013) Midterm results of the transarterial use of Onyx in the treatment of persisting type II endoleaks after EVAR. J Cardiovasc Surg 54(4):469–475Google Scholar
  57. 57.
    Müller-Wille R, Wohlgemuth WA, Heiss P, Wiggermann P, Güntner O, Schreyer AG, Hoffstetter P, Stroszczynski C, Zorger N (2013) Transarterial embolization of type II endoleaks after EVAR: the role of ethylene vinyl alcohol copolymer (Onyx). Cardiovasc Interv Radiol 36(5):1288–1295CrossRefGoogle Scholar
  58. 58.
    Funaki B, Birouti N, Zangan SM, Ha TGV, Lorenz JM, Navuluri R, Skelly CL, Leef JA (2012) Evaluation and treatment of suspected type II endoleaks in patients with enlarging abdominal aortic aneurysms. J Vasc Interv Radiol 23:866–872CrossRefPubMedCentralPubMedGoogle Scholar
  59. 59.
    Sheehan MK, Barbato J, Compton CN, Zajko A, Rhee R, Makaroun MS (2004) Effectiveness of coiling in the treatment of endoleaks after endovascular repair. J Vasc Surg 40:430–434CrossRefPubMedGoogle Scholar
  60. 60.
    Hongo N, Kiyosue H, Shuto R, Kamei N, Miyamoto S, Tanoue S, Mori H (2014) Double coaxial microcatheter technique for transarterial aneurysm sac embolization of type II endoleaks after endovascular abdominal aortic repair. J Vasc Interv Radiol 25(5):709–716CrossRefPubMedGoogle Scholar
  61. 61.
    Sarac TP, Gibbons C, Vargas L, Liu J, Srivastava S, Bena J, Mastracci T, Kashyap VS, Clair D (2012) Long-term follow-up of type II endoleak embolization reveals the need for close surveillance. J Vasc Surg 55:33–40CrossRefPubMedGoogle Scholar
  62. 62.
    Gallagher KA, Ravin RA, Meltzer AJ, Khan MA, Coleman DM, Graham AR, Aiello F, Shrikhande G, Connolly PH, Dayal R, Karwowski JK (2012) Midterm outcomes after treatment of type II endoleaks associated with aneurysm sac expansion. J Endovasc Ther 19:182–192CrossRefPubMedGoogle Scholar
  63. 63.
    Kasirajan K, Matteson B, Marek JM, Langsfeld M (2003) Technique and results of transfemoral superselective coil embolization of type II lumbar endoleak. J Vasc Surg 38:61–66CrossRefPubMedGoogle Scholar
  64. 64.
    Jouhannet C, Alsac J-M, Julia P, Sapoval M, El Batti S, Di Primio M, Fabiani JN (2014) Reinterventions for type 2 endoleaks with enlargement of the aneurismal sac after endovascular treatment of abdominal aortic aneurysms. Ann Vasc Surg 28(1):192–200CrossRefPubMedGoogle Scholar
  65. 65.
    Rial R, Serrano FJ, Vega M, Rodriguez R, Martin A, Mendez J, Mendez R, Santos E, Gallego J (2004) Treatment of type II endoleaks after endovascular repair of abdominal aortic aneurysms: translumbar puncture and injection of thrombin into the aneurysm sac. Eur J Vasc Endovasc Surg 27:333–335CrossRefPubMedGoogle Scholar
  66. 66.
    Uthoff H, Katzen BT, Gandhi R, Peña CS, Benenati JF, Geisbüsch P (2012) Direct percutaneous sac injection for postoperative endoleak treatment after endovascular aortic aneurysm repair. J Vasc Surg 56:965–972CrossRefPubMedGoogle Scholar
  67. 67.
    Khaja, Park AW, Swee W, Evans AJ, Fritz Angle J, Turba UC, Sabri SS, Matusomoto AH (2013) Treatment of type II endoleak using Onyx with long-term imaging follow-up. Cardiovasc Interv Radiol 37(3):613–622CrossRefGoogle Scholar
  68. 68.
    Baum RA, Carpenter JP, Golden MA, Velazquez OC, Clark TW, Stavropoulous SW, Cope C, Fairman RM (2002) Treatment of type 2 endoleaks after endovascular repair of abdominal aortic aneurysms: comparison of transarterial and translumbar techniques. J Vasc Surg 35:23–29CrossRefPubMedGoogle Scholar
  69. 69.
    Aziz A, Menias CO, Sanchez LA, Picus D, Saad N, Rubin BG, Curci JA, Geraghty PJ (2012) Outcomes of percutaneous endovascular intervention for type II endoleak with aneurysm expansion. J Vasc Surg 55:1263–1267CrossRefPubMedGoogle Scholar
  70. 70.
    Stavropoulos SW, Park J, Fairman R, Carpenter J (2009) Type 2 endoleak embolization comparison: translumbar embolization versus modified transarterial embolization. J Vasc Interv Radiology 20(10):1299–1302CrossRefGoogle Scholar
  71. 71.
    Mansueto G, Cenzi D, Scuro A, Gottin L, Griso A, Gumbs AA, Mucelli RP (2007) Treatment of type II endoleak with a transcatheter transcaval approach: results at 1-year follow-up. J Vasc Surg 45:1120–1127CrossRefPubMedGoogle Scholar
  72. 72.
    Midulla M, Perini P, Sundareyan R, Lazguet Y, Dehaene A, Goyault G, Martinelli T, Haulon S (2012) Transcatheter transcaval embolization of a type II endoleak after EVAR using a transseptal needle-sheath system. Vasc Endovasc. Surg. 46(5):410–413CrossRefGoogle Scholar
  73. 73.
    Wisselink W, Cuesta MA, Berenda FJ, van den Berg FG, Rauwerda JA (2000) Retroperitoneal endoscopic ligation of lumbar and inferior mesenteric arteries as a treatment of persistent endoleak after endoluminal aortic aneurysm repair. J Vasc Surg 31:1240–1244CrossRefPubMedGoogle Scholar
  74. 74.
    Richardson WS, Sternbergh WC 3rd, Money SR (2003) Laparoscopic inferior mesenteric artery ligation: an alternative for the treatment of type II endoleaks. J Laparoendosc Adv Surg Tech A 13(6):355–358CrossRefPubMedGoogle Scholar
  75. 75.
    Ho P, Law WL, Tung PH, Poon JT, Ting AC, Cheng SW (2004) Laparoscopic transperitoneal clipping of the inferior mesenteric artery for the management of type II endoleak after endovascular repair of an aneurysm. Surg Endosc 18:870PubMedGoogle Scholar
  76. 76.
    Kolvenbach R, Pinter L, Raghunandan M et al (2002) Laparoscopic remodelling of abdominal aortic aneurysms after endovascular exclusion: a technical description. J Vasc Surg 36:1267–1270CrossRefPubMedGoogle Scholar
  77. 77.
    Lin JC, Eun D, Shrivastava A, Shepard AD, Reddy DJ (2009) Total robotic ligation of inferior mesenteric artery for type II endoleak after endovascular aneurysm repair. Ann Vasc Surg 23(2):255.e19–255.e21CrossRefGoogle Scholar
  78. 78.
    Linsen MA, Daniles L, Cuesta MA, Wisselink W (2011) Endoscopic type 2 endoleak repair following endovascular aortic aneurysm repair: acute results and follow-up experience. Vascular 19(3):121–125CrossRefPubMedGoogle Scholar
  79. 79.
    Halak M, McDonnell CO, Muhlmann MD, Baker SR (2007) Open surgical treatment of aneurysmal sac expansion following endovascular abdominal aneurysm repair: solution for an unresolved clinical dilemma. Vascular 15(4):201–204CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2014

Authors and Affiliations

  1. 1.Radiology, Ground Floor, St. James WingSt. George’s Healthcare NHS TrustLondonEngland, UK

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