Type II endoleak embolization after endovascular abdominal aortic aneurysm repair with use of real-time three-dimensional fluoroscopic needle guidance

J Vasc Interv Radiol. 2010 Sep;21(9):1443-7. doi: 10.1016/j.jvir.2010.05.016. Epub 2010 Aug 12.


Current treatment for type II endoleak includes transarterial embolization and translumbar puncture, but each method has its drawbacks. With real-time three-dimensional fluoroscopy guidance, a cone-beam computed tomography (CT) image is created in which the needle trajectory is determined. The trajectory is superimposed on the fluoroscopy image, allowing real-time needle placement for precise embolization. We have used this method to treat five patients with complex type II endoleaks. All interventions were successful and uncomplicated. At 6-month follow-up, CT scan showed no recurrences. Direct puncture and injection with real-time three-dimensional fluoroscopy guidance shows encouraging results as treatment for complex type II endoleaks after endovascular abdominal aortic aneurysm repair (EVAR).

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiography, Digital Subtraction
  • Aortic Aneurysm, Abdominal / surgery*
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Contrast Media
  • Embolization, Therapeutic*
  • Endoleak / diagnostic imaging
  • Endoleak / etiology
  • Endoleak / therapy*
  • Endovascular Procedures* / adverse effects
  • Fluoroscopy
  • Humans
  • Imaging, Three-Dimensional*
  • Male
  • Punctures
  • Radiographic Image Interpretation, Computer-Assisted
  • Radiography, Interventional / methods*
  • Time Factors
  • Tomography, X-Ray Computed*
  • Treatment Outcome


  • Contrast Media