Endoleak

Postoperative hemorrhage from an endovascular AORTIC ANEURYSM repaired with endoluminal placement of stent grafts (BLOOD VESSEL PROSTHESIS IMPLANTATION). It is associated with pressurization, expansion, and eventual rupture of the aneurysm.

Also Known As:

Networked: 1354 relevant articles (44 outcomes, 84 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Aneurysm (Aneurysms)
2.	Endoleak
3.	Rupture
4.	Abdominal Aortic Aneurysm
5.	Thrombosis (Thrombus)

Experts

1.	Greenberg, Roy K: 16 articles (10/2014 - 05/2003)
2.	Schoder, Maria: 15 articles (09/2014 - 10/2002)
3.	Lammer, Johannes: 15 articles (09/2014 - 10/2002)
4.	Fairman, Ronald M: 15 articles (11/2012 - 01/2002)
5.	Carpenter, Jeffrey P: 15 articles (11/2010 - 02/2002)
6.	Moll, Frans L: 14 articles (05/2014 - 02/2004)
7.	Alric, Pierre: 13 articles (01/2016 - 06/2002)
8.	Stavropoulos, S William: 13 articles (09/2015 - 05/2003)
9.	Mehta, Manish: 13 articles (04/2015 - 04/2003)
10.	Donas, Konstantinos P: 12 articles (10/2015 - 10/2007)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Endoleak:

1.	Fibrin Tissue Adhesive (Fibrin Sealant)IBA 08/01/2010 - "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." 10/01/2011 - "After fibrin glue injection, 50 (98.0%) of the 51 endoleaks were successfully resolved, and intra-sac pressure (including systolic, diastolic, mean pressures, pulse pressure, and the mean pressure indexes) decreased significantly in these cases. " 10/01/2011 - "From August 2002 to June 2010, among the 953 EVAR patients, 51 (5.4%) patients underwent intraoperative transcatheter fibrin glue sac embolization to resolve type I endoleak persisting after initial intraoperative maneuvers to close the leak or in necks too short or angulated for cuff placement. " 12/01/2010 - "Fibrin glue sac embolization to eliminate type I endoleak after EVAR yielded excellent results in our experience, effectively and durably resolving the leaks. " 12/01/2010 - "After fibrin glue injection, 41 (97.6%) of the 42 endoleaks were resolved using a mean 15 ± 10 mL of glue. "
2.	ethylene-vinyl alcohol copolymerIBA 10/01/2013 - "To determine the feasibility and efficacy of transarterial endoleak embolization using the liquid embolic agent ethylene vinyl alcohol copolymer (Onyx). " 07/01/2012 - "Direct embolization was performed via sac puncture with ethylene vinyl alcohol copolymer in two of the latter five patients and eliminated endoleaks in both. " 06/01/2014 - "The purpose of our study is to report our experience with the use of an ethylene vinyl alcohol copolymer (Onyx) in an off-label fashion for the treatment of type II endoleak after endovascular repair of the thoracic (TEVAR) and abdominal (EVAR) aorta. " 04/01/2011 - "The aim of this study was to investigate whether the liquid embolic agent Onyx, an ethylene vinyl alcohol copolymer, can be used to seal type 1 endoleaks during endovascular aortic repair (EVAR). " 03/01/2015 - "Reduction of TC significantly decreased CT artefact intensity of ethylene-vinyl-alcohol-copolymer and increased visibility of endoleak re-perfusion (p < 0.000). "
3.	Contrast MediaIBA 06/01/2007 - "The aim of this study is to evaluate the efficacy of Cadence Contrast Pulse Sequencing ultrasound technique with second generation contrast agents in detecting endoleaks, and to compare the results with data obtained from CTA. " 04/01/2002 - "The sensitivity of the ultrasound techniques to detect endoleak improved with the use of ultrasound contrast media, ranging from a low of 12% with unenhanced color Doppler to 50% with enhanced power Doppler. " 08/01/2013 - "CEUS imaging appears to be as good as MS-CT angiography in the detection of endoleaks in the follow-up after EVAR, with the added advantages of no radiation dose and no nephrotoxicity of the contrast agents. " 09/01/2010 - "Endoleaks that are occult on CT can be detected by MRI with blood pool contrast agents. " 04/01/2008 - "Our cases illustrate the usability of a new contrast agent and a new imaging strategy for visualizing slow-flow endoleaks that can not be imaged using currently used imaging techniques with conventional contrast agents."
4.	Tranexamic Acid (AMCA)FDA Link 08/01/2015 - "eComment: Treating endoleak type 2 and disseminated intravascular coagulopathy after EVAR with tranexamic acid: the efficacy of killing two birds with one stone." 08/01/2015 - "Reappearance of the endoleak when tranexamic acid was accidentally stopped and its re-closure after the resumption of tranexamic acid treatment confirmed causality. " 08/01/2015 - "This singular experience extends prior published observations that administration of prophylactic tranexamic acid before thoracic endovascular aneurysm repair and endovascular aneurysm repair resulted in significantly greater shrinkage, particularly if an endoleak or coagulopathy was present. " 08/01/2015 - "Orally administered tranexamic acid mitigated and partially reversed two and a half years of progressive aneurysmal expansion and closed a persistent endoleak after thoracic endovascular aneurysm repair and endovascular aneurysm repair for coexisting lesions. " 01/01/2000 - "Thrombosis was influenced by systemic tranexamic acid, fibrinogen in the aneurysm sac, Gelfoam in both endoleak and aneurysm sac, and by Histoacryl glue in the endoleak. "
5.	glucuronyl glucosamine glycan sulfate (Vessel)IBA 03/01/2002 - "CDU scan is effective in the identification of the type of endoleak, the delineation of the vessel involved, and the hemodynamic information not available with any other testing method. " 01/01/2003 - "The purpose of this study was to determine whether intrasac spectral Doppler flow velocities can predict whether or not a type II endoleak will spontaneously seal and to relate intrasac flow to preoperative branch vessel anatomy. " 09/01/2002 - "We reviewed our endovascular registry data, hospital charts, and radiologic studies of patients with type II endoleaks and analyzed the results in those treated with PTCE of the inflow vessel. " 11/01/2015 - "Among surviving patients, four required early endovascular re-intervention for type III endoleak (n = 2), type Ia endoleak (n = 1), or target vessel cannulation failure (n = 1). " 11/01/2015 - "Target vessel events and endoleaks were the 2 major indications for reintervention, accounting for 63.8%. "
6.	Warfarin (Coumadin)FDA LinkGeneric 08/01/2013 - "The purpose of this study was to determine whether chronic anticoagulation therapy with warfarin is associated with an increased incidence of endoleak and thus increased need for reintervention after EVAR. " 02/01/2014 - "The pooled effects analysis found that EVAR patients receiving long-term warfarin postoperatively had significantly more endoleaks of any type (OR 1.77, 95% CI 1.26 to 2.48, p=0.001) as well as persistent type II endoleaks (OR 1.58, 95% CI 1.05 to 2.37, p=0.03) compared with patients not on anticoagulation; however, there was no statistically significant difference in the reintervention rate between the groups. " 08/01/2010 - "The overall endoleak rate was 13 of 24 in the warfarin group and 25 of 103 in the antiplatelet group (P = .004). " 08/01/2010 - "We investigated whether warfarin anticoagulation was an independent risk factor for endoleak after EVAR for AAA. " 04/01/2002 - "Warfarin treatment is not associated with an increase in the incidence rate of early or delayed postoperative endoleaks. "
7.	Polyethylene Terephthalates (Polyethylene Terephthalate)IBA 04/01/2014 - "However, no study has rigorously examined endoleak rates in Dacron landing zones vs native aorta. " 04/01/2014 - "In cases of a borderline native aortic landing zone, a hybrid procedure to create an adequate Dacron landing zone may be warranted to decrease the risk of type I endoleak and treatment failure." 04/01/2014 - "Endograft deployment within long-segment (landing zone length of >4-5 cm) Dacron represents a durable option for aortic repair and was associated with a 0% rate of type I endoleak. " 04/01/2014 - "Cumulative type I endoleak rates were equivalent between the three types of landing zone (native aorta, 3.7%; Dacron, 2.5%; endograft, 0%; P = .44). " 04/01/2014 - "Comparison of attachment site endoleak rates in Dacron versus native aorta landing zones after thoracic endovascular aortic repair."
8.	HydrogelIBA 07/01/2005 - "Prophylactic residual aneurysmal sac embolization with expandable hydrogel embolic devices for endoleak prevention: preliminary study in dogs." 07/01/2005 - "To explore the feasibility and efficacy of residual aneurysmal sac (RAS) embolization with the expandable hydrogel embolic device (EHED) in prevention of endoleaks in a surgically created and endoluminally treated abdominal aortic aneurysm (AAA). " 12/01/2015 - "Hydrogel-coated coils have been used in the management of visceral aneurysms, high-flow vascular arteriovenous fistulae, and endoleaks after endovascular thoracic and abdominal aneurysm repair. " 04/01/2009 - "To describe two hydrogel embolic materials, the alginate-based EmboGel and the polyethylene glycol diacrylate-based UltraGel and examine their use as embolic agents in in vitro models of abdominal aortic aneurysm (AAA) endoleak and saccular aneurysms. "
9.	EnbucrilateIBA 01/01/2010 - "Between 2000 and 2007, six patients with type I (n = 4) or II (n = 2) endoleaks were treated by the percutaneous transabdominal approach using embolization with N-butyl cyanoacrylate with or without coils. " 03/01/2007 - "This case report involves endoleak embolization using metallic coils along with the liquid embolic agent n-butyl cyanoacrylate (n-BCA)." 03/01/2007 - "Embolization of a Recurrent Type 2 Endoleak Using the Liquid Embolic n-Butyl Cyanoacrylate." 06/01/2005 - "Translumbar embolization was used to treat 11 type 2 endoleaks in nine patients with the liquid embolic agent n-butyl cyanoacrylate (NBCA). " 11/01/2006 - "Bowel ischemia can complicate treatment of type II endoleak with liquid or semiliquid agents such as n-butyl cyanoacrylate (NBCA) if nontarget embolization of the inferior mesenteric artery (IMA) occurs. "
10.	Ethiodized Oil (Ethiodol)FDA Link 01/01/2015 - "Accumulation of (99m)Tc-HSAD corresponding to endoleaks disappeared after embolization, but CT evaluation of embolization was impeded by artifacts of NBCA-Lipiodol and metallic coils. " 06/01/2015 - "Contrast-enhanced computed tomography 1 and 8 months later showed no Lipiodol washout in the aneurysm sac, no endoleak recurrence, and no expansion of the excluded aneurysm. " 02/01/2013 - "At 6 and 3 months after embolotherapy, respectively, the NBCA-lipiodol filled the endoleak sacs and the communicating channels up to the respective feeding arteries; no enlargement of the aneurysms was observed. " 05/01/2014 - "To evaluate the feasibility and efficacy of transarterial sac embolization with a mixture of N-butyl cyanoacrylate and ethiodized oil (Lipiodol; Guerbet Japan, Tokyo, Japan) (NBCA-LPD) for type II endoleaks after endovascular aortic repair (EVAR) using a double coaxial microcatheter technique. " 02/01/2013 - "Fluoroscopy and cone-beam computed tomography-guided direct percutaneous endoleak sac embolization with n-butyl-2-cyanoacrylate (NBCA)-lipiodol was performed using the coaxial technique, which resulted in complete embolization of the endoleak sac. "

Therapies and Procedures

1.	Stents 01/01/2011 - "Endoleak is a frequent issue after initial covered stent placement, but can be eliminated or dramatically reduced to minimal endoleak by additional covered stent placement and/or balloon reinflation. " 08/01/2009 - "Re-dilation of the stent avoided the endoleak in 2 patients; in 1 of these 2 patients, formerly improved symptoms recurred the next morning and the ipsilateral ICA was occluded with detachable balloons. " 02/01/2007 - "In 3 cases, endoleak persisted after the first stent was placed, but this was eliminated by placement of a second stent. " 07/01/2004 - "In a prospective, clinical study of EVAR in 163 patients over 60 months, using four different aortic stent devices, we demonstrated an intraprocedural type-II endoleak rate, before exclusion, of 3% (5/163). " 06/01/2001 - "To study factors that might contribute to intraoperative proximal type I endoleak and to evaluate the placement of giant Palmaz stents as a therapeutic option. "
2.	Transplants (Transplant) 04/01/2003 - "in the absence of a graft-related endoleak (23/25 patients), endovascular repair resulted in a significant reduction in intra-sac pulse pressure (median ratio 0.31 IQR 0.10-0.46). " 06/01/2013 - "There was no acute branch occlusion or type I endoleak from the IIA or chimney graft gutters on imaging studies up to 6 months. " 02/01/2012 - "The purpose of this study was to describe the use of a bifurcated endovascular graft to treat endograft migration with major endoleaks. " 12/01/2011 - "Endoleaks with the AneuRx graft: a longer-term, single-center study." 08/01/2010 - "Patients randomized to elective EVAR in EVAR Trial 1 or 2 were followed for serious graft-related complications (type 2 endoleaks excluded) and reinterventions. "
3.	Endovascular Procedures 05/01/2006 - "One type I endoleak was successfully treated with a rescue endovascular procedure, four cases of type I endoleak resolved completely without any further intervention, no new onset endoleak was discovered. " 02/01/2006 - "Fourteen (25%) patients had an early endoleak, of whom 5 were treated successfully with a secondary endovascular procedure, 2 necessitated open surgical conversion, and 7 were treated conservatively, with spontaneous sealing of the endoleak in 3. In 53 (91%) in whom computed tomographic follow-up was longer than 3 months (mean, 30.1 months, range, 3 to 85), the aortic diameter along the stented segment decreased in 24, was stable in 19, and increased in 10 patients. " 04/01/2012 - "Among 66 patients with 30-day imaging studies evaluable for endoleak, 4 (6.1%) had type I and 7 (10.6%) had type II endoleak; there were no types III or IV. Within 30 days, no secondary endovascular procedures were required due to endoleak. " 09/01/2015 - "There were no statistically significant differences at 1 year follow up in type I endoleaks, secondary endovascular procedures, or all cause mortality. " 09/01/2015 - "Endovascular techniques are the favored modality for endoleak repair and include techniques to bridge the endoleak defector and embolize the endoleak nidus and inflow/outflow vessels. "
4.	Ligation 12/01/2015 - "Attempts were undertaken to treat the source of endoleak including coil micro-embolisation of lumbar arteries and subsequent open ligation of the inferior mesenteric artery, but they failed to eliminate the endoleak. " 08/01/2013 - "Prevention of type II endoleak by laparoscopic inferior mesenteric artery ligation." 06/01/2012 - "Most OCs after EVAR are associated with significant morbidity and mortality, except when electively treating an isolated type II endoleak with ligation of branches and preservation of the endograft." 06/01/2012 - "No deaths occurred in a subgroup of patients who underwent endograft preservation with selective ligation of culprit vessels for type II endoleak. " 06/01/2012 - "Endograft preservation was used for type II endoleak in all but one patient by selective ligation of the culprit arteries (lumbar in four, inferior mesenteric artery in five, and middle sacral in one). "
5.	Injections 01/01/2009 - "The authors describe a novel treatment method whereby successful seal of a distal type 1 endoleak was achieved with coil embolization and a liquid injectable embolic agent. "