PMC5576093_01
Preoperative ultrasound of patient with flow seen into the abdominal aortic aneurysm sac as well as within the right and left limbs of the bifurcated Dacron graft. The arrow points to the area of endoleak (A). Postoperative image indicating Type 2 endoleak repair with no flow from the lumbar vessels into the aneurysm sac, with flow seen in both limbs. The arrow points to location of the Onyx injection (B).
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One month later, a repeat aorto-iliac duplex scan was significant for return of the Type 2 endoleak in direct proximity to the area where Onyx embolization material was placed (Fig. 1A). Ultrasound determined that there was no evidence of persistent filling of the aortic aneurysm sac (Fig. 1B).
The Onyx cast present in the paired lumbar vessels causing the Type 2 endoleak.
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At this point, 0.5 mL of Onyx was injected and demonstrated complete closure of both lumbar vessels along with the absence of flow into the aneurysm sac (Figure 2, Figure 3).
Successful translumbar embolization after the second attempt with a 22 chiba needle into the aneurysm sac.
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At this point, 0.5 mL of Onyx was injected and demonstrated complete closure of both lumbar vessels along with the absence of flow into the aneurysm sac (Figure 2, Figure 3).