Embolization of perigraft leaks after endovascular stent-graft treatment of aortic aneurysms

PURPOSE: Perigraft leak is one of the significant problems associated with transluminal placement of stent-grafts in the treatment of aortic aneurysms. This report describes the authors' experience with transcatheter coil embolization for the treatment of perigraft leaks. MATERIALS AND METHODS: Ten patients who underwent transluminal placement of stent-grafts for the treatment of aortic aneurysms were treated. All patients had one or more tracts between the aortic wall and stent-graft or between two stent-grafts, resulting in residual aneurysm filling. All tracts were embolized by means of transcatheter deposition of platinum or steel coils. RESULTS: In all patients, all tracts were embolized completely and residual aneurysm filling was eliminated. Complete thrombosis of the aneurysm was confined on follow-up spiral computed tomography in all 10 cases. Two cases required two embolization procedures to completely embolize the tracts. No recurrent leaks or aneurysm expansions were identified on follow-up studies. CONCLUSIONS: Although long-term effectiveness remains to be proved, the initial results with transcatheter coil embolization of tracts are encouraging and suggest this technique is a safe and effective method for the management of perigraft leaks after endovascular placement of stent-grafts.