type 2 el haulon armv 28092013
TRANSCRIPT
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Technique et Traitement des endofuites de type 2
S Haulon, J Sobocinski, M Midulla, T Resch, N Dias
Lille, FranceMalmö, Sweden
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ENDOFUITES White, JVIR 1991
3-15% 15-50% 5-10%
HAUT DEBIT
φsiologique
φsiologique
“persistence of blood flow within the aneurysmal sac outside the lumen of the endograft”
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Algorithme EF type 2
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• Origines:Alimentation rétrograde du sac anévrismal par une a. Lombaire ou a. Mésentérique inf or IMA
ENDOFUITES type 2
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Embolisation AMI Préventive?
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TYPE 2 – hypogastrique
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TYPE 2 – AMI
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TYPE 2 – Quelle(s) artère(s) alimente(nt) le sac?
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Inflow and Outflow
Inflow? Outflow?
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outflow
inflow
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Options thérapeutiques
Embolisation par Coil voie
Trans Arterielle
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ONYXGLUE
Embolisation transartérielle
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Ponction translombaire –embolisation directe
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Ponction
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Anévrysmographie
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Guide de pression 0.014’’
20 G needle0.014’’ PressureWire
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PressionAorta
Sac
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Alternatives
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EVC 2012 AAA Endoleaks
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Suivi
• À 1 an: du diamètre de 1 cm diamètre + EF type 2 and 1b
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2ème Procédure
• Angiographie
• Embolisation Type 2
• Embolisation iliaque interne + jambage
d’extension iliaque
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Suivi après embolisation d’une EF
Type II
• Evaluation CTA rendue difficile par la présence de
matériel d’embolisation
– Appréciation du diamètre
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Conclusions
• Bon résultat de la ponction lombaire
• Comme alternative en cas d’échec de ttt
transartériel
• Options alternatives