Aneurysm Sac “Thrombization” and Stabilization in EVAR: A Technique to Reduce the Risk of Type II Endoleak
Purpose: To evaluate the reduction in type II endoleak risk after introducing a new prevention method, “thrombization” or clotting of the aneurysm sac, during endovascular aneurysm repair (EVAR) versus the standard EVAR technique. Methods: From September 1999 to December 2008, 469 consecutive patien...
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| Veröffentlicht in: | Journal of endovascular therapy 2010-08, Vol.17 (4), p.517-524 |
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| creator | Ronsivalle, Salvatore Faresin, Francesca Franz, Francesca Rettore, Carlo Zanchetta, Mario Olivieri, Armando |
| description | Purpose:
To evaluate the reduction in type II endoleak risk after introducing a new prevention method, “thrombization” or clotting of the aneurysm sac, during endovascular aneurysm repair (EVAR) versus the standard EVAR technique.
Methods:
From September 1999 to December 2008, 469 consecutive patients underwent EVAR for AAA at our institution. In 2003, the injection of fibrin glue with or without microcoils into the aneurysm sac was added to the EVAR treatment plan (“thrombization” technique). Patients who did not meet the inclusion criterion (at least 1-year follow-up imaging) were censored at the end of 2007, leaving 404 patients eligible for the study: 224 patients (210 men; mean age 71.9±8.5 years, range 25–88) undergoing EVAR alone from September 1999 to May 2003 (group 1)compared to 180 patients (161 men; mean age 72.6±8 years, range 46–89) who underwent EVAR + thrombization from June 2003 to December 2006 (group 2).
Results:
The 2 treatment groups were similar with regard to aneurysm morphology. No allergic or anaphylactic reactions were encountered related to the fibrin glue. Over median follow-up times of 72 months in group 1 and 26 months in group 2, there were 34 (15.2%) endoleaks in group 1 versus 4 (2.2%) in group 2 (p |
| doi_str_mv | 10.1583/09-3004.1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_748948809</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1583_09-3004.1</sage_id><sourcerecordid>2117563311</sourcerecordid><originalsourceid>FETCH-LOGICAL-c408t-8804fe3cdb857813a818e51ea704a5ba4cc52f58d86d10c71cb1388a33ca30fa3</originalsourceid><addsrcrecordid>eNpl0UFP2zAUB3ALMQHrOOwLIIsD0w5h78V24nCrqrJVQprUdrtGjuPQQGKXODmUEx8EvhyfBFctm7Sd_GT99H9P7xHyGeEShWTfIIsYAL_EA3KCgosIhYDDbR0nUQKxPCYfvb8DiDFGPCLHMSQS0yQ7IXZszdBtfEsXStPXp-flqnNtUT-qvnb29emFKlvSRa-Kutl_0trS6e_x_IqO6dLola0fBkN7R-emHHSoVobOa39PXUWXm7Whsxmd2tI1Rt1_Ih8q1Xhzun9H5Nf1dDn5Ed38_D6bjG8izUH2kZTAK8N0WUiRSmRKojQCjUqBK1EorrWIKyFLmZQIOkVdIJNSMaYVg0qxEfmyy113Lkzn-7ytvTZNo6xxg89TLjMeumRBnv8j79zQ2TBcQAnPIIM4oK87pDvnfWeqfN3Vreo2OUK-PUEOWb49QY7Bnu0Dh6I15R_5vvMALnbAq1vzt9v_SW-2IoyF</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>746490902</pqid></control><display><type>article</type><title>Aneurysm Sac “Thrombization” and Stabilization in EVAR: A Technique to Reduce the Risk of Type II Endoleak</title><source>MEDLINE</source><source>SAGE Publications</source><source>Alma/SFX Local Collection</source><creator>Ronsivalle, Salvatore ; Faresin, Francesca ; Franz, Francesca ; Rettore, Carlo ; Zanchetta, Mario ; Olivieri, Armando</creator><creatorcontrib>Ronsivalle, Salvatore ; Faresin, Francesca ; Franz, Francesca ; Rettore, Carlo ; Zanchetta, Mario ; Olivieri, Armando</creatorcontrib><description>Purpose:
To evaluate the reduction in type II endoleak risk after introducing a new prevention method, “thrombization” or clotting of the aneurysm sac, during endovascular aneurysm repair (EVAR) versus the standard EVAR technique.
Methods:
From September 1999 to December 2008, 469 consecutive patients underwent EVAR for AAA at our institution. In 2003, the injection of fibrin glue with or without microcoils into the aneurysm sac was added to the EVAR treatment plan (“thrombization” technique). Patients who did not meet the inclusion criterion (at least 1-year follow-up imaging) were censored at the end of 2007, leaving 404 patients eligible for the study: 224 patients (210 men; mean age 71.9±8.5 years, range 25–88) undergoing EVAR alone from September 1999 to May 2003 (group 1)compared to 180 patients (161 men; mean age 72.6±8 years, range 46–89) who underwent EVAR + thrombization from June 2003 to December 2006 (group 2).
Results:
The 2 treatment groups were similar with regard to aneurysm morphology. No allergic or anaphylactic reactions were encountered related to the fibrin glue. Over median follow-up times of 72 months in group 1 and 26 months in group 2, there were 34 (15.2%) endoleaks in group 1 versus 4 (2.2%) in group 2 (p<0.0001). The incidence of type II endoleak was 0.25/100 person-months for group 1 versus 0.07/100 person-months for group 2. The preventive sac thrombization technique was significantly associated with a reduced risk of type II endoleak (HR 0.13, 95% CI 0.05 to 0.36; p<0.0001) regardless of the type of stent-graft fixation (infrarenal versus suprarenal).
Conclusion:
The preventive method of intrasac “thrombization” using fibrin glue injection with or without the insertion of coils proves to be a simple, low cost, safe, and effective technique to significantly reduce the risk of type II endoleaks irrespective of the endograft used.</description><identifier>ISSN: 1526-6028</identifier><identifier>EISSN: 1545-1550</identifier><identifier>DOI: 10.1583/09-3004.1</identifier><identifier>PMID: 20681769</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Aneurysms ; Aortic Aneurysm, Abdominal - diagnostic imaging ; Aortic Aneurysm, Abdominal - surgery ; Aortic Aneurysm, Abdominal - therapy ; Aortography - methods ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation - adverse effects ; Blood Vessel Prosthesis Implantation - instrumentation ; Catheters ; Combined Modality Therapy ; Embolization, Therapeutic - instrumentation ; Female ; Fibrin Tissue Adhesive - administration & dosage ; Humans ; Injections, Intralesional ; Italy ; Kaplan-Meier Estimate ; Male ; Medical imaging ; Middle Aged ; Proportional Hazards Models ; Prosthesis Design ; Prosthesis Failure ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stents ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome</subject><ispartof>Journal of endovascular therapy, 2010-08, Vol.17 (4), p.517-524</ispartof><rights>2010 International Society of Endovascular Specialists</rights><rights>Copyright Allen Press Publishing Services Aug 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-8804fe3cdb857813a818e51ea704a5ba4cc52f58d86d10c71cb1388a33ca30fa3</citedby><cites>FETCH-LOGICAL-c408t-8804fe3cdb857813a818e51ea704a5ba4cc52f58d86d10c71cb1388a33ca30fa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1583/09-3004.1$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1583/09-3004.1$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20681769$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ronsivalle, Salvatore</creatorcontrib><creatorcontrib>Faresin, Francesca</creatorcontrib><creatorcontrib>Franz, Francesca</creatorcontrib><creatorcontrib>Rettore, Carlo</creatorcontrib><creatorcontrib>Zanchetta, Mario</creatorcontrib><creatorcontrib>Olivieri, Armando</creatorcontrib><title>Aneurysm Sac “Thrombization” and Stabilization in EVAR: A Technique to Reduce the Risk of Type II Endoleak</title><title>Journal of endovascular therapy</title><addtitle>J Endovasc Ther</addtitle><description>Purpose:
To evaluate the reduction in type II endoleak risk after introducing a new prevention method, “thrombization” or clotting of the aneurysm sac, during endovascular aneurysm repair (EVAR) versus the standard EVAR technique.
Methods:
From September 1999 to December 2008, 469 consecutive patients underwent EVAR for AAA at our institution. In 2003, the injection of fibrin glue with or without microcoils into the aneurysm sac was added to the EVAR treatment plan (“thrombization” technique). Patients who did not meet the inclusion criterion (at least 1-year follow-up imaging) were censored at the end of 2007, leaving 404 patients eligible for the study: 224 patients (210 men; mean age 71.9±8.5 years, range 25–88) undergoing EVAR alone from September 1999 to May 2003 (group 1)compared to 180 patients (161 men; mean age 72.6±8 years, range 46–89) who underwent EVAR + thrombization from June 2003 to December 2006 (group 2).
Results:
The 2 treatment groups were similar with regard to aneurysm morphology. No allergic or anaphylactic reactions were encountered related to the fibrin glue. Over median follow-up times of 72 months in group 1 and 26 months in group 2, there were 34 (15.2%) endoleaks in group 1 versus 4 (2.2%) in group 2 (p<0.0001). The incidence of type II endoleak was 0.25/100 person-months for group 1 versus 0.07/100 person-months for group 2. The preventive sac thrombization technique was significantly associated with a reduced risk of type II endoleak (HR 0.13, 95% CI 0.05 to 0.36; p<0.0001) regardless of the type of stent-graft fixation (infrarenal versus suprarenal).
Conclusion:
The preventive method of intrasac “thrombization” using fibrin glue injection with or without the insertion of coils proves to be a simple, low cost, safe, and effective technique to significantly reduce the risk of type II endoleaks irrespective of the endograft used.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aneurysms</subject><subject>Aortic Aneurysm, Abdominal - diagnostic imaging</subject><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Aortic Aneurysm, Abdominal - therapy</subject><subject>Aortography - methods</subject><subject>Blood Vessel Prosthesis</subject><subject>Blood Vessel Prosthesis Implantation - adverse effects</subject><subject>Blood Vessel Prosthesis Implantation - instrumentation</subject><subject>Catheters</subject><subject>Combined Modality Therapy</subject><subject>Embolization, Therapeutic - instrumentation</subject><subject>Female</subject><subject>Fibrin Tissue Adhesive - administration & dosage</subject><subject>Humans</subject><subject>Injections, Intralesional</subject><subject>Italy</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>Proportional Hazards Models</subject><subject>Prosthesis Design</subject><subject>Prosthesis Failure</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stents</subject><subject>Time Factors</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><issn>1526-6028</issn><issn>1545-1550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpl0UFP2zAUB3ALMQHrOOwLIIsD0w5h78V24nCrqrJVQprUdrtGjuPQQGKXODmUEx8EvhyfBFctm7Sd_GT99H9P7xHyGeEShWTfIIsYAL_EA3KCgosIhYDDbR0nUQKxPCYfvb8DiDFGPCLHMSQS0yQ7IXZszdBtfEsXStPXp-flqnNtUT-qvnb29emFKlvSRa-Kutl_0trS6e_x_IqO6dLola0fBkN7R-emHHSoVobOa39PXUWXm7Whsxmd2tI1Rt1_Ih8q1Xhzun9H5Nf1dDn5Ed38_D6bjG8izUH2kZTAK8N0WUiRSmRKojQCjUqBK1EorrWIKyFLmZQIOkVdIJNSMaYVg0qxEfmyy113Lkzn-7ytvTZNo6xxg89TLjMeumRBnv8j79zQ2TBcQAnPIIM4oK87pDvnfWeqfN3Vreo2OUK-PUEOWb49QY7Bnu0Dh6I15R_5vvMALnbAq1vzt9v_SW-2IoyF</recordid><startdate>201008</startdate><enddate>201008</enddate><creator>Ronsivalle, Salvatore</creator><creator>Faresin, Francesca</creator><creator>Franz, Francesca</creator><creator>Rettore, Carlo</creator><creator>Zanchetta, Mario</creator><creator>Olivieri, Armando</creator><general>SAGE Publications</general><general>Allen Press Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201008</creationdate><title>Aneurysm Sac “Thrombization” and Stabilization in EVAR: A Technique to Reduce the Risk of Type II Endoleak</title><author>Ronsivalle, Salvatore ; Faresin, Francesca ; Franz, Francesca ; Rettore, Carlo ; Zanchetta, Mario ; Olivieri, Armando</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-8804fe3cdb857813a818e51ea704a5ba4cc52f58d86d10c71cb1388a33ca30fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aneurysms</topic><topic>Aortic Aneurysm, Abdominal - diagnostic imaging</topic><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Aortic Aneurysm, Abdominal - therapy</topic><topic>Aortography - methods</topic><topic>Blood Vessel Prosthesis</topic><topic>Blood Vessel Prosthesis Implantation - adverse effects</topic><topic>Blood Vessel Prosthesis Implantation - instrumentation</topic><topic>Catheters</topic><topic>Combined Modality Therapy</topic><topic>Embolization, Therapeutic - instrumentation</topic><topic>Female</topic><topic>Fibrin Tissue Adhesive - administration & dosage</topic><topic>Humans</topic><topic>Injections, Intralesional</topic><topic>Italy</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Middle Aged</topic><topic>Proportional Hazards Models</topic><topic>Prosthesis Design</topic><topic>Prosthesis Failure</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Stents</topic><topic>Time Factors</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ronsivalle, Salvatore</creatorcontrib><creatorcontrib>Faresin, Francesca</creatorcontrib><creatorcontrib>Franz, Francesca</creatorcontrib><creatorcontrib>Rettore, Carlo</creatorcontrib><creatorcontrib>Zanchetta, Mario</creatorcontrib><creatorcontrib>Olivieri, Armando</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Source</collection><collection>ProQuest - Health & Medical Complete保健、医学与药学数据库</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endovascular therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ronsivalle, Salvatore</au><au>Faresin, Francesca</au><au>Franz, Francesca</au><au>Rettore, Carlo</au><au>Zanchetta, Mario</au><au>Olivieri, Armando</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Aneurysm Sac “Thrombization” and Stabilization in EVAR: A Technique to Reduce the Risk of Type II Endoleak</atitle><jtitle>Journal of endovascular therapy</jtitle><addtitle>J Endovasc Ther</addtitle><date>2010-08</date><risdate>2010</risdate><volume>17</volume><issue>4</issue><spage>517</spage><epage>524</epage><pages>517-524</pages><issn>1526-6028</issn><eissn>1545-1550</eissn><abstract>Purpose:
To evaluate the reduction in type II endoleak risk after introducing a new prevention method, “thrombization” or clotting of the aneurysm sac, during endovascular aneurysm repair (EVAR) versus the standard EVAR technique.
Methods:
From September 1999 to December 2008, 469 consecutive patients underwent EVAR for AAA at our institution. In 2003, the injection of fibrin glue with or without microcoils into the aneurysm sac was added to the EVAR treatment plan (“thrombization” technique). Patients who did not meet the inclusion criterion (at least 1-year follow-up imaging) were censored at the end of 2007, leaving 404 patients eligible for the study: 224 patients (210 men; mean age 71.9±8.5 years, range 25–88) undergoing EVAR alone from September 1999 to May 2003 (group 1)compared to 180 patients (161 men; mean age 72.6±8 years, range 46–89) who underwent EVAR + thrombization from June 2003 to December 2006 (group 2).
Results:
The 2 treatment groups were similar with regard to aneurysm morphology. No allergic or anaphylactic reactions were encountered related to the fibrin glue. Over median follow-up times of 72 months in group 1 and 26 months in group 2, there were 34 (15.2%) endoleaks in group 1 versus 4 (2.2%) in group 2 (p<0.0001). The incidence of type II endoleak was 0.25/100 person-months for group 1 versus 0.07/100 person-months for group 2. The preventive sac thrombization technique was significantly associated with a reduced risk of type II endoleak (HR 0.13, 95% CI 0.05 to 0.36; p<0.0001) regardless of the type of stent-graft fixation (infrarenal versus suprarenal).
Conclusion:
The preventive method of intrasac “thrombization” using fibrin glue injection with or without the insertion of coils proves to be a simple, low cost, safe, and effective technique to significantly reduce the risk of type II endoleaks irrespective of the endograft used.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>20681769</pmid><doi>10.1583/09-3004.1</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Aneurysms Aortic Aneurysm, Abdominal - diagnostic imaging Aortic Aneurysm, Abdominal - surgery Aortic Aneurysm, Abdominal - therapy Aortography - methods Blood Vessel Prosthesis Blood Vessel Prosthesis Implantation - adverse effects Blood Vessel Prosthesis Implantation - instrumentation Catheters Combined Modality Therapy Embolization, Therapeutic - instrumentation Female Fibrin Tissue Adhesive - administration & dosage Humans Injections, Intralesional Italy Kaplan-Meier Estimate Male Medical imaging Middle Aged Proportional Hazards Models Prosthesis Design Prosthesis Failure Retrospective Studies Risk Assessment Risk Factors Stents Time Factors Tomography, X-Ray Computed Treatment Outcome |
| title | Aneurysm Sac “Thrombization” and Stabilization in EVAR: A Technique to Reduce the Risk of Type II Endoleak |
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