Marchiori Elena, Ibrahim Abdulhakim, Schäfers Johannes Frederik, Oberhuber Alexander
Department of Vascular and Endovascular Surgery, University Hospital Münster, 48149 Münster, Germany.
Biomedicines. 2022 Jun 18;10(6):1442. doi: 10.3390/biomedicines10061442.
(1) Successful endovascular repair for abdominal aortic aneurysms is based on the complete exclusion of the aneurysm sac from the systemic circulation. Type Ia endoleak (ELIA) is defined as the persistent perfusion of the aneurysm sac due to incomplete proximal sealing between aorta and endograft, with a consequent risk of rupture and death. Endoleak embolization has been sporadically reported as a viable treatment for ELIA. (2) A systematic literature search in PubMed of all publications in English about ELIA embolization was performed until February 2022. Research methods and reporting were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Data regarding patient numbers, technical success (endoleak absence at control angiography), reinterventions, clinical and imaging follow-up, and outcomes were collected and examined by two independent authors. (3) Twenty-one papers (12 original articles, 9 case reports) reported on 126 patients (age range 58-96 years) undergoing ELIA embolization 0-139 months after the index procedure. Indication for embolization was most often founded on unfavorable anatomy and patient comorbidities. Embolic agents used include liquid embolic agents, coils, plugs and combinations thereof. Technical success in this highly selected cohort ranged from 67-100%; the postprocedural complication rate within 30 days was 0-24%. ELIA recurrence was reported as 0-42.8%, with a secondary ELIA-embolization-intervention success rate of 50-100%. At a follow-up at 0-68 months, freedom from sac enlargement amounted to 76-100%, freedom from ELIA to 66.7-100%. (4) Specific literature about ELIA embolization is scant. ELIA embolization is a valuable bailout strategy for no-option patients; the immediate technical success rate is high and midterm and long-term outcomes are acceptable.
（1）腹主动脉瘤的成功血管腔内修复基于将瘤腔完全排除在体循环之外。Ia型内漏（ELIA）定义为由于主动脉与血管内移植物之间近端密封不完全导致瘤腔持续灌注，从而有破裂和死亡风险。内漏栓塞术作为ELIA的一种可行治疗方法已有零星报道。（2）截至2022年2月，在PubMed上对所有关于ELIA栓塞术的英文出版物进行了系统的文献检索。研究方法和报告遵循系统评价和Meta分析的首选报告项目（PRISMA）声明。由两位独立作者收集并检查有关患者数量、技术成功（对照血管造影时无内漏）、再次干预、临床和影像学随访及结果的数据。（3）21篇论文（12篇原创文章，9篇病例报告）报道了126例患者（年龄范围58 - 96岁）在初次手术后0至139个月接受ELIA栓塞术。栓塞的指征最常基于不利的解剖结构和患者合并症。使用的栓塞剂包括液体栓塞剂、弹簧圈、封堵器及其组合。在这个经过高度筛选的队列中，技术成功率为67% - 100%；30天内的术后并发症发生率为0% - 24%。ELIA复发率报告为0% - 42.8%，二次ELIA栓塞干预成功率为50% - 100%。在0至68个月的随访中，瘤腔无增大的比例为76% - 100%，无ELIA的比例为66.7% - 100%。（4）关于ELIA栓塞术的具体文献很少。ELIA栓塞术是一种对无其他选择的患者有价值的补救策略；即刻技术成功率高，中期和长期结果可以接受。
