Effect of transarterial embolization on persistent type II endoleaks after endovascular aneurysm

Objective To evaluate the clinical effectiveness of transarterial embolization in persistent type Ⅱ endoleak after endovascular aneurysm repair(EVAR). Methods Eligible studies concerning treatment by transarterial embolization in patients with persistent type Ⅱ endoleak after EVAR were identified from electronic database, cross-reference search and pertinent articles. All relevant studies were systematically reviewed and the data were extracted by two independent reviewers. The study endpoints were technical success, clinical success, mortality, and complications. Results A total of 56 studies were selected for comprehensive review. No randomized controlled trials were identified. Seven patient series,comprising 129 type Ⅱ endoleaks, matched the selection criteria. The rate of technical success ranged from 69.7% to 100.0% (95% CI: 78.3% ±7.3%). During the follow-up, the clinical success rate was 100. 0% in three studies using the criterion without increase of the aneurysm diameter by the end of followup ; and in other 3 studies the disappearance rates of type Ⅱ endoleak were 61.5%, 20.0%, and 78.9% respectively. No incidence of serious complications, rupture of aneurysmal sac, and intra-operational death were reported. Conclusion Transarterial embolization is a main option in treating type Ⅱ endoleak without serious complications. Despite the high rate of technical and clinical success of the procedure, long term follow-up and randomized contrast trials are needed to confirm the efficacy. Key words: Embolism; Aortic aneurysm,abdominal; Meta-analysis; Type Ⅱ endoleak