Purpose: To report a single-center experience with transcatheter embolization of type I endoleaks using the liquid embolic agent Onyx, an ethylene vinyl alcohol copolymer.Methods: Eight patients (4 men; mean age 74.8 years, range 63-86) with 10 type I endoleaks (6 abdominal and 4 thoracic) diagnosed 2 days to 9 years after endovascular repair were treated with Onyx embolization because cuff extension was precluded by an insufficient landing zone in 6 cases and an unsuitable aortic diameter in 2. Endoleaks were accessed with a 4-F diagnostic catheter and a coaxially introduced dimethylsulfoxide-compatible microcatheter. Onyx-34 was predominantly applied due to its high viscosity; patent side branches were coil embolized prior to Onyx delivery in 3 cases.Results: Technical success of the procedure was achieved in all cases. The mean volume of Onyx used for abdominal endoleaks was 11.8 nnL (range 3.0-25.5) and 19.4 mL (range 4.5-31.5) for thoracic endoleaks. The average duration of the procedure was 76.7 minutes (range 34.5-110.6), and the average radiation dose area product was 18.8 cGy*cm(2) (range 10.6-55.8). Reperfusion of the endoleak was detected in one case 2 days after the procedure. A second case showed an occluded endoleak but a small trace of contrast between the aortic wall and the stent-graft. Non-target embolization was not found in any case. Mean follow-up was 13.2 months (range 8-24). The mean reduction in diameters for thoracic aneurysms after 6 and 12 months was 0.4 and 0.9 cm, respectively, and 0.6 and 1.2 cm, respectively, for abdominal aneurysms.Conclusion: Transcatheter embolization of type I endoleaks using Onyx is a simple, safe, and sustainable treatment option with a high primary success rate for cases in which stent-graft extension is not possible. The benefit of additional coil embolization remains uncertain.

Purpose To compare in a prospective noninferiority study optical coherence tomography (OCT) and intravascular ultrasound (IVUS) in popliteal and infrapopliteal vessels. Materials and Methods OCT and IVUS images of 112 popliteal and infrapopliteal arterial segments were prospectively obtained from 16 patients with peripheral arterial occlusive disease. Three observers evaluated the corresponding OCT and IVUS images for image quality, artifact frequency, discriminability of vessel wall layers, and plaque composition. Measurements of the lumen, vessel, and plaque areas were compared for both modalities. Results The intrareader and interreader reproducibility of plaque tissue discrimination (0.88 vs 0.75), overall image quality, and vessel wall layer discriminability were significantly higher for OCT (all P < .001). Artifact frequency was higher in OCT, constraining the imaging of the tibioperoneal trunk. The results of measurements of the lumen and vessel area were comparable for both modalities (correlation > 0.9, P < .001). Plaque area measurements differed (correlation 0.8, P < .01) because OCT underestimated it. The OCT procedure caused vessel spasms in two patients. Conclusions OCT imaging of infrapopliteal arteries is feasible and safe and provides high image quality. It enables an accurate assessment of vessel lumen, wall, and plaque. Compared with IVUS, OCT images provide excellent image quality and superior visualization of vessel wall layers and different plaque components. The penetration depth of OCT restricts its use to suitable vessel regions.

Case reportEndovascular treatment of acute limb ischemia caused by an intravascularly deployed bioabsorbable plug of a vascular closure deviceDaniel Maxien, Barbara Behrends, Karla M. Eberhardt, Tobias Saam, Sven F. Thieme, Maximilian F. Reiser, and Marcus TreitlDaniel Maxien Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany Search for more papers by this author, Barbara Behrends Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany Search for more papers by this author, Karla M. Eberhardt Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany Search for more papers by this author, Tobias Saam Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany Search for more papers by this author, Sven F. Thieme Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany Search for more papers by this author, Maximilian F. Reiser Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany Search for more papers by this author, and Marcus Treitl Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany Search for more papers by this authorPublished Online:March 13, 2013https://doi.org/10.1024/0301-1526/a000260PDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInReddit SectionsMoreFiguresReferencesRelatedDetailsCited byEndovascular foreign body removal of a MynxGrip polyethylene glycol (PEG) sealant embolus using a cerebral stent retriever1 March 2021 | CVIR Endovascular, Vol. 4, No. 1Successful bailout procedure for acute popliteal artery occlusion associated with EXOSEAL® vascular closure device: a case report21 March 2019 | Journal of Medical Case Reports, Vol. 13, No. 1Large-scale experience with an anchorless vascular closure device in a real-life clinical setting8 October 2014 | Clinical Research in Cardiology, Vol. 104, No. 2A Novel Technique to Retrieve a Maldeployed Vascular Closure Device1 February 2015 | Journal of Endovascular Therapy, Vol. 22, No. 1 Volume 42Issue 2March 2013ISSN: 0301-1526eISSN: 1664-2872 InformationVasa (2013), 42, pp. 144-148 https://doi.org/10.1024/0301-1526/a000260.© 2013Hogrefe AGKeywordsVessel occlusionvascular closure deviceExoSealendovascular treatmentendovascular interventionacute limb ischemiaPDF download