PMC6424687_01
Computed tomography angiogram three months after chimney endovascular aneurysm repair demonstrating a persistent type Ia endoleak.
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The CTA at three months showed a persistent gutter related type Ia endoleak connected with lumbar arteries without additional aneurysmal sac enlargement (Fig. 1).
Sequence of technical steps during the embolization procedure. (A) Advance of the 0.014'' wire in the gutter. (B) Confirmation of the combined type Ia endoleak and type II endoleak via lumbar arteries. (C) Use of coils (Axium) to fill the gap and occlude the type II endoleak. (D) Additional use of Onyx Liquid Embolic System (arrow) for the small gutters and completion angiography showing no evidence of endoleak.
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Onyx Liquid Embolic System (Medtronic) (Fig. 2). On completion angiography the type Ia endoleak had disappeared.
Computed tomography angiography after coil assisted Onyx embolization showing no evidence of endoleak, in the (A) sagittal and (B) axial projections; arrows point to chimney grafts.
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The post-operative CTA confirmed this successful result (Fig. 3).
Magnetic resonance angiography at 10 months demonstrating absence of endoleak.
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A 10 month magnetic resonance angiogram showed no evidence of endoleak, and the aneurysm diameter remained stable (Fig. 4).