Transcaval endoleak embolization using intravascular ultrasound: A step-by-step guide

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Techniques in Vascular and Interventional Radiology Pub Date : 2025-03-01 DOI:10.1016/j.tvir.2025.101023

Achintya A. Patel MD, Michael J. Miller MD

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引用次数: 0

Abstract

Type II endoleaks are common benign complications that occur following endovascular aneurysm repair (EVAR). When traditional transarterial embolization fails in the management of these endoleaks, alternative approaches such as the transcaval approach can be attempted. The transcaval approach can be performed from either right internal jugular or common femoral vein access sites. The technique utilizes intravascular ultrasound or landmark fluoroscopy to visualize direct needle access into the aneurysm sac. Once access is obtained, the source of the endoleak can be embolized with either coils, liquid embolics, or thrombin. The technique is well tolerated by the vast majority of patients. Technical challenges include the need for a capable assistant and approach vectors. Possible complications include iatrogenic type III endoleaks, graft and/or coil pack infections, and persistent or recurrent type II endoleaks. This article will review indications and evaluation of patients for transcaval endoleak embolization, describe the procedure in a step-by-step fashion, and discuss potential technical challenges and complications.

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经颅腔腔内漏栓塞血管内超声：一步一步的指导

II型内漏是血管内动脉瘤修复术后常见的良性并发症。当传统的经动脉栓塞治疗失败时，可以尝试其他方法，如经颅入路。经颅入路可从右颈内静脉或股总静脉入路进行。该技术利用血管内超声或地标性透视来可视化直接进入动脉瘤囊的针。一旦获得通道，可以用线圈、液体栓塞剂或凝血酶栓塞内漏源。绝大多数患者都能很好地耐受这项技术。技术上的挑战包括需要一个有能力的助手和接近向量。可能的并发症包括医源性III型内漏、移植物和/或线圈包感染以及持续或复发的II型内漏。本文将回顾经颅腔内腔栓塞的适应症和评估，逐步描述手术过程，并讨论潜在的技术挑战和并发症。

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来源期刊

Techniques in Vascular and Interventional Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

2.70

自引率

0.00%

发文量

期刊介绍： Interventional radiology is an area of clinical diagnosis and management that is highly technique-oriented. Therefore, the format of this quarterly journal, which combines the visual impact of an atlas with the currency of a journal, lends itself perfectly to presenting the topics. Each issue is guest edited by a leader in the field and is focused on a single clinical technique or problem. The presentation is enhanced by superb illustrations and descriptive narrative outlining the steps of a particular procedure. Interventional radiologists, neuroradiologists, vascular surgeons and neurosurgeons will find this a useful addition to the clinical literature.