Objective: To evaluate the clinical effectiveness of transarterial embolization in persistent type II endoleak after endovascular aneurysm repair (EVAR).
Methods: Eligible studies concerning treatment by transarterial embolization in patients with persistent type II endoleak after EVAR were identified from electronic database, cross-reference search and pertinent articles. All relevant studies were systematically reviewed and the data were extracted by two independent reviewers. The study endpoints were technical success, clinical success, mortality, and complications.
Results: A total of 56 studies were selected for comprehensive review. No randomized controlled trials were identified. Seven patient series, comprising 129 type II endoleaks, matched the selection criteria. The rate of technical success ranged from 69.7% to 100.0% (95% CI: 78.3% +/- 7.3%). During the follow-up, the clinical success rate was 100.0% in three studies using the criterion without increase of the aneurysm diameter by the end of followup; and in other 3 studies the disappearance rates of type II endoleak were 61.5%, 20.0%, and 78.9% respectively. No incidence of serious complications, rupture of aneurysmal sac, and intra-operational death were reported.
Conclusion: Transarterial embolization is a main option in treating type II endoleak without serious complications. Despite the high rate of technical and clinical success of the procedure, long term follow-up and randomized contrast trials are needed to confirm the efficacy.