Initial Outcomes of Embolization for Type II Endoleak: Comparison of n-Butyl Cyanoacrylate-Ethiodized Oil Mixture with n-Butyl Cyanoacrylate-Ethiodized Oil-Ethanol Mixture.

PURPOSE: This study aimed to compare the safety and effectiveness N-butyl cyanoacrylate (NBCA)-lipiodol mixture (NL) and NBCA-lipiodol-ethanol mixture (NLE) embolization for Type II endoleak (T2EL) after endovascular aortic repair (EVAR).

MATERIALS AND METHODS: This study included 32 patients with 49 procedures who underwent T2EL embolization between January 2008 and June 2022. Cases with no follow-up after embolization, technical failure, treatment with coil only, T1EL at the embolization, and re-embolization were excluded. The resultant final cohort included 24 patients (14 men and 10 women; mean age, 83.3 [interquartile range (IQR) 77-89] years) who underwent initial T2EL embolization, with 15 patients in the NL group and 9 patients in the NLE group. The two groups were compared in terms of adverse events, freedom from sac enlargement, and freedom from reintervention.

RESULTS: The follow-up period after embolization for T2EL was 960±1007 days in the NL group and 484±192 days in the NLE group, without significant differences. No adverse events above moderate were observed in either group. The freedom from sac enlargement rate at 1 year was 65.0% in the NL group and 87.5% in the NLE group (P=0.03). The freedom from reintervention rate at 1 year was 69.2% in the NL group and 100.0% in the NLE group (P=0.02).

CONCLUSION: The NLE group had significantly higher rates of freedom from sac enlargement and reintervention at 1 year compared to the NL group. These results suggest that T2EL embolization with NLE may be more effective than with NL.