Analysis of Early Efficacy and Safety of Spring Coil Embolization for Type II Endoleak after Endovascular Aneurysm Repair

Objective: To investigate the early efficacy of spring coil embolization for type II endoleak after endovascular aneurysm repair (EVAR) and analyze its safety. Methods: 115 patients who were diagnosed with abdominal aortic aneurysm (AAA) and underwent EVAR in our hospital from January 2019 to December 2021 were chosen as the research objects. Among them, 58 patients with spring coil embolism were set as the experimental group and 57 patients without spring coil embolism were set as the control group. The clinical data of the two groups were comparatively analyzed. Results: There was no obvious difference in the technical successful rate, the clinical successful rate and surgery time between the two groups, but the exposure time of the control group was significantly shorter than that of the experimental group. In the control group, one patient suffered from wound infection in the inguinal region and was healed after the open surgery of debridement, and another one suffered from type Ⅰ B endoleak within 30 days after surgery and recovered after the secondary endovascular surgery of extending distal landing zones. In the experimental group, the arterial ischemia of right lower extremity occurred in one patient after surgery and the symptom disappeared after interventional thrombolytic therapy. The incidence of type II endoleak in the experimental group was significantly lower than that in the control group during the 1 year and 2 years of follow-up. The follow-up found that 18 patients in the control group had type II endoleak, including 15 cases with large tumor cavities (volume ≥ 128cm ³ ), while 7 patients in the experimental group had type II endoleak, including 5 cases with large tumor cavities. Regression model established by binary logistic regression analysis showed that EVAR without embolism in tumor cavity and the volume of tumor cavity ≥ 128 cm ³ were statistically significant variables, indicating that EVAR without embolism in tumor cavity and large tumor cavity were risk factors of type II endoleak. For the small tumor cavities, the incidence of type II endoleak in the control group was slightly higher than that in the experimental group, with no statistical significance between the two groups ( P > 0.05). For the large tumor cavities, the incidence of type II endoleak in the experimental group was significantly lower than that in the control group, with a statistically significant difference. Conclusion: The intraoperative spring coil embolization in tumor cavities has a better application effect on the high-risk population of type II endoleak, with higher safety, especially in large tumor cavities, which has a high clinical promotion and application value.