Endovascular Aneurysm Sac Embolization for Treatment of Ruptured Aneurysms in the Aortoiliac Segment Using N-Butyl-Cyanoacrylate
<b>Background</b> Aneurysmal rupture in the aortoiliac segment is a severe, life-threatening condition. Nowadays, in addition to surgical treatment, the implantation of a covered stent graft constitutes a feasible, minimally invasive treatment option. A novel approach is the add-on of tr...
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MDPI AG
2023-03-01
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| Online Access: | https://www.mdpi.com/2075-1729/13/4/919 |
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| author | Karim Mostafa Marie Schierenbeck Jens Trentmann Hannes Gottschalk Julian Andersson Julian Pfarr Malte Sieren Olav Jansen Philipp J. Schäfer |
| author_facet | Karim Mostafa Marie Schierenbeck Jens Trentmann Hannes Gottschalk Julian Andersson Julian Pfarr Malte Sieren Olav Jansen Philipp J. Schäfer |
| author_sort | Karim Mostafa |
| collection | DOAJ |
| description | <b>Background</b> Aneurysmal rupture in the aortoiliac segment is a severe, life-threatening condition. Nowadays, in addition to surgical treatment, the implantation of a covered stent graft constitutes a feasible, minimally invasive treatment option. A novel approach is the add-on of transarterial aneurysm sac embolization with N-butyl-cyanoacrylate (NBCA). Here, we report our experience of performing this add-on embolization procedure after endovascular aneurysm repair for complex ruptured aneurysms of the aortoiliac segment. <b>Material and Methods</b> We describe six patients (mean age of 75.2 years; all male) with ruptured aneurysms in the visceral aortic and aortoiliac segment in whom a high-volume transarterial aneurysm sac embolization was performed as an add-on therapy to the implantation of an aortic prosthesis. The aim of this add-on intervention was to achieve the definite embolization of the aneurysmal rupture site and to ensure the best possible aneurysmal sealing. We report the feasibility, technical success, and considerations of using NBCA as well as clinical and follow-up imaging results, given their availability. <b>Results</b> Technical success was achieved in all cases. Clinical success was achieved in four cases. No periprocedural complications or reinterventions were reported. The mean full procedure time was 107.8 min. The mean radiation dose was 12,966.1 cGy/cm<sup>2</sup>. A mean amount of 10.7 mL of NBCA mixed with lipiodol in a 1:3 to 1:5 ratio was used for all patients. Available follow-up imaging up to 36 months after the procedure showed no aneurysm progression or endoleaks. In two patients, the NBCA cast had almost fully dissolved over the course of follow-up. <b>Conclusions</b> Our study underscores the notion that aneurysm sac embolization using high volumes of NBCA with ethiodized oil as an embolic agent is a feasible and add-on treatment option for optimizing the exclusion of the aneurysm from patients with ruptured aneurysms in the aortoiliac segment. |
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| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-11T04:49:49Z |
| publishDate | 2023-03-01 |
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| spelling | doaj.art-36015b01ff3046578eb2273ad0344c142023-11-17T20:05:27ZengMDPI AGLife2075-17292023-03-0113491910.3390/life13040919Endovascular Aneurysm Sac Embolization for Treatment of Ruptured Aneurysms in the Aortoiliac Segment Using N-Butyl-CyanoacrylateKarim Mostafa0Marie Schierenbeck1Jens Trentmann2Hannes Gottschalk3Julian Andersson4Julian Pfarr5Malte Sieren6Olav Jansen7Philipp J. Schäfer8Department for Radiology and Neuroradiology, University Hospital Schleswig Holstein, Campus Kiel, 24105 Kiel, GermanyDepartment for Radiology and Neuroradiology, University Hospital Schleswig Holstein, Campus Kiel, 24105 Kiel, GermanyDepartment for Radiology and Neuroradiology, University Hospital Schleswig Holstein, Campus Kiel, 24105 Kiel, GermanyDepartment for Radiology and Neuroradiology, University Hospital Schleswig Holstein, Campus Kiel, 24105 Kiel, GermanyDepartment for Radiology and Neuroradiology, University Hospital Schleswig Holstein, Campus Kiel, 24105 Kiel, GermanyDepartment for Radiology and Neuroradiology, University Hospital Schleswig Holstein, Campus Kiel, 24105 Kiel, GermanyDepartment of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, 23569 Lübeck, GermanyDepartment for Radiology and Neuroradiology, University Hospital Schleswig Holstein, Campus Kiel, 24105 Kiel, GermanyDepartment for Radiology and Neuroradiology, University Hospital Schleswig Holstein, Campus Kiel, 24105 Kiel, Germany<b>Background</b> Aneurysmal rupture in the aortoiliac segment is a severe, life-threatening condition. Nowadays, in addition to surgical treatment, the implantation of a covered stent graft constitutes a feasible, minimally invasive treatment option. A novel approach is the add-on of transarterial aneurysm sac embolization with N-butyl-cyanoacrylate (NBCA). Here, we report our experience of performing this add-on embolization procedure after endovascular aneurysm repair for complex ruptured aneurysms of the aortoiliac segment. <b>Material and Methods</b> We describe six patients (mean age of 75.2 years; all male) with ruptured aneurysms in the visceral aortic and aortoiliac segment in whom a high-volume transarterial aneurysm sac embolization was performed as an add-on therapy to the implantation of an aortic prosthesis. The aim of this add-on intervention was to achieve the definite embolization of the aneurysmal rupture site and to ensure the best possible aneurysmal sealing. We report the feasibility, technical success, and considerations of using NBCA as well as clinical and follow-up imaging results, given their availability. <b>Results</b> Technical success was achieved in all cases. Clinical success was achieved in four cases. No periprocedural complications or reinterventions were reported. The mean full procedure time was 107.8 min. The mean radiation dose was 12,966.1 cGy/cm<sup>2</sup>. A mean amount of 10.7 mL of NBCA mixed with lipiodol in a 1:3 to 1:5 ratio was used for all patients. Available follow-up imaging up to 36 months after the procedure showed no aneurysm progression or endoleaks. In two patients, the NBCA cast had almost fully dissolved over the course of follow-up. <b>Conclusions</b> Our study underscores the notion that aneurysm sac embolization using high volumes of NBCA with ethiodized oil as an embolic agent is a feasible and add-on treatment option for optimizing the exclusion of the aneurysm from patients with ruptured aneurysms in the aortoiliac segment.https://www.mdpi.com/2075-1729/13/4/919endovascular embolization of ruptured aneurysmstransarterial embolizationruptured aneurysm treatmentN-butyl-cyanoacrylate embolization |
| spellingShingle | Karim Mostafa Marie Schierenbeck Jens Trentmann Hannes Gottschalk Julian Andersson Julian Pfarr Malte Sieren Olav Jansen Philipp J. Schäfer Endovascular Aneurysm Sac Embolization for Treatment of Ruptured Aneurysms in the Aortoiliac Segment Using N-Butyl-Cyanoacrylate Life endovascular embolization of ruptured aneurysms transarterial embolization ruptured aneurysm treatment N-butyl-cyanoacrylate embolization |
| title | Endovascular Aneurysm Sac Embolization for Treatment of Ruptured Aneurysms in the Aortoiliac Segment Using N-Butyl-Cyanoacrylate |
| title_full | Endovascular Aneurysm Sac Embolization for Treatment of Ruptured Aneurysms in the Aortoiliac Segment Using N-Butyl-Cyanoacrylate |
| title_fullStr | Endovascular Aneurysm Sac Embolization for Treatment of Ruptured Aneurysms in the Aortoiliac Segment Using N-Butyl-Cyanoacrylate |
| title_full_unstemmed | Endovascular Aneurysm Sac Embolization for Treatment of Ruptured Aneurysms in the Aortoiliac Segment Using N-Butyl-Cyanoacrylate |
| title_short | Endovascular Aneurysm Sac Embolization for Treatment of Ruptured Aneurysms in the Aortoiliac Segment Using N-Butyl-Cyanoacrylate |
| title_sort | endovascular aneurysm sac embolization for treatment of ruptured aneurysms in the aortoiliac segment using n butyl cyanoacrylate |
| topic | endovascular embolization of ruptured aneurysms transarterial embolization ruptured aneurysm treatment N-butyl-cyanoacrylate embolization |
| url | https://www.mdpi.com/2075-1729/13/4/919 |
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