Department of Radiology, Sumitomo Hospital, Osaka, Japan.
Department of Radiology, Nara Medical University, Kashihara, Japan.
J Endovasc Ther. 2022 Dec;29(6):835-838. doi: 10.1177/15266028211067730. Epub 2021 Dec 30.
To describe a technique of vascular plug penetration by a guidewire with a heavy tip load for additional embolization of a type 2 endoleak after endovascular aortic aneurysm repair (EVAR).
The technique of vascular plug penetration is effective for additional embolization of a type 2 endoleak, when large arteries such as left subclavian artery (LSA) or hypogastric artery remain patent even after the embolization of the vessel has been performed using a vascular plug and are responsible for the endoleak. A tapered guidewire with a heavy tip load enables the penetration of the disk of the plug, followed by introduction of a microcatheter into the endoleak nidus. In the presented case, the technique successfully eliminated a type 2 endoleak in a thoracic aortic aneurysm for which a patent LSA despite the embolization by a vascular plug was responsible.
The technique of vascular plug penetration allows an access to an endoleak cavity via a vascular plug placed in an aortic side branch for additional embolization of a type 2 endoleak after EVAR.
描述一种导丝尖端重载穿透血管塞的技术，用于治疗血管内主动脉瘤修复（EVAR）后 2 型内漏的额外栓塞。
即使在使用血管塞栓塞后，大动脉如左锁骨下动脉（LSA）或髂动脉仍保持通畅，导致 2 型内漏，血管塞穿透技术对额外栓塞是有效的。尖端重载的锥形导丝可穿透塞子的圆盘，然后将微导管引入内漏中心。在本病例中，该技术成功消除了胸主动脉瘤的 2 型内漏，尽管 LSA 保持通畅，但仍使用血管塞进行了栓塞。
血管塞穿透技术允许通过放置在主动脉侧支的血管塞进入内漏腔，以进行 EVAR 后 2 型内漏的额外栓塞。
