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Endovascular Management of Moyamoya Type II Endoleak Utilizing a CO2-Assisted Protection Strategy: A Case Report
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DOI：10.1177/15266028261436277.png)
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Abstract
En 中文
Purpose: To describe the successful treatment of a Moyamoya type II endoleak (T2EL) using n-butyl cyanoacrylate (NBCA) assisted by intra-arterial carbon dioxide (CO2) flow modulation in a patient with post-endovascular abdominal aortic repair (EVAR) aneurysm sac enlargement. Case Report: An 84-year-old woman developed progressive aneurysm enlargement due to a refractory Moyamoya T2EL 5 years after EVAR with an AFX II stent graft. Angiography demonstrated persistent retrograde perfusion through the inferior mesenteric artery via complex vasa vasorum-dominant collaterals. Because of unfavorable flow dynamics for embolization, CO2 was intentionally injected to transiently suppress antegrade flow from the sigmoid artery, generating a controlled to-and-fro pattern. Under these hemodynamic conditions, NBCA was carefully administered, resulting in complete occlusion of the endoleak without reflux or non-target embolization. Follow-up computed tomography (CT) at 1 year confirmed stable sac size with no re-dilation.
Keywords:
endovascular abdominal aortic repair (EVAR)
Moyamoya type II endoleak
n-butyl cyanoacrylate (NBCA)
coil embolization
intra-arterial CO2 injection
Journal
J
IF:
1.5
Papers:
127
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0
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