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

La radiologia medica volume 122, pages 154–159 (2017)Cite this article

Abstract

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.

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Acknowledgements

Our acknowledgements are for our department chair, who provided general support.

Author information

Affiliations

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

    Anna Maria Ierardi, Camilla Micieli & Federico Fontana

  2. Diagnostic and Interventional Radiology Unit, University of Milan, Viale di Rudinì 7, Milan, Italy

    Salvatore Alessio Angileri & Gianpaolo Carrafiello

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

    Nicola Rivolta & Gabriele Piffaretti

  4. Department of Radiology, “Luigi Sacco” University Hospital, Via G.B. Grassi 74, 20157, Milan, MI, Italy

    Massimo Tonolini

  5. Department of Emergency Radiology, S. Camillo Hospital, Circonvallazione Gianicolense 87, 00152, Rome, Italy

    Vittorio Miele

  6. Department of Radiology, Università degli Studi del Molise, Campobasso, CB, Italy

    Luca Brunese

Authors
  1. Anna Maria Ierardi
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  2. Camilla Micieli
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  3. Salvatore Alessio Angileri
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  4. Nicola Rivolta
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  5. Gabriele Piffaretti
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  6. Massimo Tonolini
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  7. Federico Fontana
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  8. Vittorio Miele
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  9. Luca Brunese
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  10. Gianpaolo Carrafiello
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Corresponding author

Correspondence to Gianpaolo Carrafiello.

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Authors declare to have no conflict of interest.

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This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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.

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

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Ierardi, A.M., Micieli, C., Angileri, S.A. et al. Ethylene–vinyl alcohol copolymer as embolic agent for treatment of type II endoleak: our experience. Radiol med 122, 154–159 (2017). https://doi.org/10.1007/s11547-016-0703-9

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  • DOI: https://doi.org/10.1007/s11547-016-0703-9

Keywords

  • Ethylene-vinyl alcohol copolymer
  • Onyx
  • Type II endoleak
  • Embolization