Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.180130
Jornal Vascular Brasileiro
Case Report

Tratamento de endoleak tipo 1A mediante embolização com molas: relato de caso

Treatment of type 1A endoleak using coil embolization: a case report

Sergio Quilici Belczak; Guilherme Delicato Pedroso; Lara Cote Ogawa; Paula Thume Campos; Andre Lopes Padula; Glenna Paulain Machado; Matheus Zago Soares dos Santos; Beatriz Marques Abrão

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Resumo

Resumo: No endoleak tipo 1A, a endoprótese não sela completamente o colo do aneurisma proximal, e o fluxo arterial está presente entre a parede do colo aórtico e o material do implante. Este é um relato de um caso no qual foi utilizada embolização com molas, associado a uma revisão de literatura (PubMed, LILACS e SciELO). Foram pesquisados artigos publicados nos últimos 5 anos com os descritores “endoleak 1A”, “coil embolization” e “treatment”, combinados de formas aleatórias, sendo encontrados 25 artigos. O tipo 1A ocorre em 1,1% dos pacientes após 30 dias do implante. O tratamento consiste em aumentar a vedação do implante proximal, principalmente com o uso de stents e balões para alargar a zona de aterragem ou aumentar a força radial do implante. Alguns trabalhos sugerem técnicas de embolização com cianoacrilato, cola de fibrina e uso de Onyx, mostrando taxas de sucesso superiores a 97%. Contudo, a correção de endoleaks tipo 1A mediante embolização com molas é pouco descrita.

Palavras-chave

endoleak, embolização terapêutica, tratamento

Abstract

Abstract: In a type 1A endoleak, the endograft is unable to fully seal the proximal aneurysm neck and blood flow leaks between the wall of the aortic neck and the graft material. This article reports a case in which coil embolization was used and presents a literature review (PubMed, LILACS, and SciELO). Searches were run for articles published in the past 5 years using the descriptors “endoleak 1A”, “coil embolization,” and “treatment”. Type 1A endoleak occurs in 1.1% of patients within 30 days of graft placement. Treatment of an endoleak is obligatory and usually consists of sealing the proximal graft neck using stents and balloons to expand the landing zone or to increase the radial force of the graft. Some studies have suggested using embolization techniques with cyanoacrylate, fibrin glue, and Onyx, demonstrating success rates that exceed 97%. However, correction of type 1A endoleak using coil embolization has seldom been described.
 

Keywords

endoleak, therapeutic embolization, treatment

References

Katada Y, Kondo S, Tsuboi E, Nakamura K, Rokkaku K, Irie Y. Type IA endoleak embolization after TEVAR via direct transthoracic puncture. Jpn J Radiol. 2015;33(3):169-72. http://dx.doi.org/10.1007/s11604-015-0392-7. PMid:25626572.

Ameli-Renani S, Morgan RA. Secondary interventions after endovascular aneurysm sac sealing: endoleak embolization and limb-related interventions. Semin Vasc Surg. 2016;29(1-2):61-7. http://dx.doi.org/10.1053/j.semvascsurg.2016.07.001. PMid:27823592.

Gandini R, Del Giudice C, Abrignani S, Vasili E, Pampana E, Simonetti G. Inexplicable late type ia endoleak associated with the low-profile ovation endograft in a patient with favorable neck anatomy: treatment with transcaval coil embolization. J Endovasc Ther. 2015;22(3):426-30. http://dx.doi.org/10.1177/1526602815579898. PMid:25862362.

Rusius VC, Davies R, Hopkins J, Duddy M, Smith S. Successful glue embolization of a late type 1A endoleak causing abdominal aortic aneurysm rupture. Vasc Endovascular Surg. 2011;45(2):198-201. http://dx.doi.org/10.1177/1538574410391821. PMid:21156711.

Buijs RV, Zeebregts CJ, Willems TP, Vainas T, Tielliu IF. Endograft sizing for endovascular aortic repair and incidence of endoleak type 1A. PLoS One. 2016;11(6):e0158042. http://dx.doi.org/10.1371/journal.pone.0158042. PMid:27359115.

Galiñanes EL, Hernandez E, Krajcer Z. Preliminary results of adjunctive use of endoanchors in the treatment of short neck and pararenal abdominal aortic aneurysms. Catheter Cardiovasc Interv. 2016;87(4):E154-9. http://dx.doi.org/10.1002/ccd.26351. PMid:26699436.

Klonaris C, Georgopoulos S, Markatis F, Katsargyris A, Tsigris C, Bastounis E. Endovascular repair of late abdominal aortic aneurysm rupture owing to mixed-type endoleak following endovascular abdominal aortic aneurysm repair. Vascular. 2007;15(3):167-71. http://dx.doi.org/10.2310/6670.2007.00021. PMid:17573024.

Van den Eynde W, Van Breussegem A, Joos B, Keirse K, Verbist J, Peeters P. Endovascular repair of a type 1a endoleak after Ch-EVAR with a b-EVAR. Cardiovasc Intervent Radiol. 2016;39(9):1361-3. http://dx.doi.org/10.1007/s00270-016-1388-0. PMid:27272712.

Marcelin C, Le Bras Y, Petitpierre F, et al. Embolization for persistent type IA endoleaks after chimney endovascular aneurysm repair with Onyx®. Diagn Interv Imaging. 2017;98(12):849-55. http://dx.doi.org/10.1016/j.diii.2017.04.005. PMid:28528715.

Law Y, Chan Y, Cheng S. Effectiveness of proximal intra-operative salvage Palmaz stent placement for endoleak during endovascular aneurysm repair. Hong Kong Med J. 2016;22(6):538-45. http://dx.doi.org/10.12809/hkmj154799. PMid:27779098.

Reddy NP, Ham S, Weaver F, Rowe V, Ziegler K, Han S. Repair of delayed type 1A endoleak using fenestrated and parallel endografts. Ann Vasc Surg. 2018;49:309.e7-15. http://dx.doi.org/10.1016/j.avsg.2018.01.070. PMid:29518520.
 

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