Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
August 20, 2025 · via Europe PMC
Outcome of Embolization of an Endoleak Type 2 After Placement of an Endoprosthesis for an Infrarenal Aorta Aneurysm.
Steenbeke M, Moreels N, Vermassen F, Vanlangenhove P, Hermie L, Dhondt E, Huyck L, Defreyne L.
AI summary — for doctors, generated from the abstract only
In a long-term study of a common post-aneurysm-repair leak type (type 2 endoleak), blocking the leak reduced the risk of aneurysm rupture, though more than half of patients still experienced some aneurysm growth after the procedure, and leak recurrence negatively affected overall treatment success.
What was studied
A retrospective study of 48 patients (58 total procedures) who underwent transarterial or translumbar embolization (blocking) for a growing type 2 endoleak after endovascular abdominal aortic aneurysm repair (2001-2022), examining the effect on aneurysm sac evolution and rupture risk, comparing the two embolization approaches.
Key findings
- After initial embolization procedures, aneurysm sac size increased in 56.5% of patients, remained stable in 30.4%, and decreased (regressed) in 13.0%.
- Recurrence of the leak significantly reduced overall clinical success, which was achieved in only 43.5% of patients overall (defined as no significant sac growth after treatment).
- No difference in aneurysm sac outcome was found between the two embolization approaches (through an artery versus through the lower back).
- Aneurysm rupture occurred in 4 patients overall, but only 1 of these ruptures was specifically attributable to an isolated type 2 endoleak; increases in aneurysm sac size were not significantly associated with overall survival.
Clinical relevance
The findings support that embolization of a growing type 2 endoleak is generally a safe treatment option that can reduce rupture risk, though the authors note it has only moderate overall clinical success (43.5%), meaning many patients may still experience aneurysm growth despite treatment, supporting continued surveillance and potential need for repeat embolization procedures in some patients.
Who should care
Limitations
Retrospective study spanning more than 20 years (practice patterns and embolization materials likely changed substantially over this period, which is not addressed); the relatively small sample size (48 patients) and low rupture event rate (4 patients) limit statistical power to draw strong conclusions about rupture risk factors.
Embolization for a growing type 2 endoleak after aneurysm repair achieved only moderate overall success (43.5%), though rupture specifically attributable to this leak type was rare, occurring in only 1 of 48 treated patients.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
The aim of this study is to investigate the effect of transarterial (TA) and translumbar (TL) embolization of a type 2 endoleak (T2EL) after endovascular aneurysm repair (EVAR) of an infrarenal abdominal aortic aneurysm (AAA) on the evolution and rupture of the aneurysmal sac.
Methods
A retrospective study was conducted including patients who underwent TA or TL embolization for a growing T2EL after EVAR from April 2001 to August 2022. Demographic data, used endograft, radiological data of the AAA and T2EL, embolization agents, techniques (TA or TL approach), and angiographical outcomes were collected from 48 patients with a total of 58 embolizations. The primary clinical outcome was rupture of the AAA. Secondary outcomes included T2EL recurrence, re-embolization of T2EL, aneurysm sac growth (≥5 mm), and mortality. Clinical success was defined as the absence of a 5 mm or greater increase in the aneurysm sac diameter.
Results
After primary T2EL embolizations, an increase in aneurysm sac was seen in 56.5% (n = 26), stability in 30.4% (n = 14), and regression in 13.0% (n = 6). Recurrence of T2EL had a significant impact on clinical success. No difference in sac size or evolution after the TA and TL embolization was noted. Rupture was found in 4 patients, but in only 1 patient it was caused by an isolated T2EL. The effect of increase in aneurysm sac size on overall survival was not statistically significant. Additionally, no associations were observed between the outcome and clinical factors including gender, obesity, chronic obstructive pulmonary disease, diabetes, hypertension, hypercholesterolemia, smoking, technique, used embolic agents, and time from endoleak onset to embolization.
Conclusion
In this retrospective study, 1 AAA rupture was attributable to an isolated T2EL out of 48 patients, with a clinical success rate of 43.5%.Clinical ImpactAlthough the impact of a type 2 endoleak (T2EL) on the outcome of an endovascular repaired abdominal aortic aneurysm is not yet clarified, in daily practice, the endovascular embolization is considered as a safe and effective option. Elimination or reduction of the volume of the endoleak can be obtained and can probably prevent aortic rupture, which is reassuring for the treating physician and the patient. The embolization of the T2EL reduces the need for extra imaging or hospitalizations, lowers the risk of complications and minimizes healthcare costs. This study contributes to the knowledge and treatment of T2EL, supporting clinicians in making better informed decisions, ultimately optimizing patient care. Moreover, this research found no outcome differences between the embolization techniques.
DOI
10.1177/15266028251363477
PMID
40832980
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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