• Shota Ohba, Masashi Shimohira, Takuya Hashizume, Masahiro Muto, Kengo Ohta, Yusuke Sawada, Akihiro Mizuno, Yosuke Nakai, Hisao Suda, and Yuta Shibamoto.
• Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
• J. Endovasc. Ther. 2020 Oct 1; 27 (5): 828-835.

PurposeTo evaluate the feasibility and safety of sac embolization with N-butyl cyanoacrylate (NBCA) in emergency endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (AAA) and iliac artery aneurysm (IAA) in comparison to EVAR without sac embolization.Materials And MethodsBetween February 2012 and December 2019, among 44 consecutive patients with ruptured AAA or IAA, 29 underwent EVAR. Of these, 22 patients (median age 77.5 years; 18 men) had concomitant sac embolization using NBCA; the remaining 7 patients (median age 88 years; 6 men) underwent EVAR without sac embolization and form the control group. The technical success, clinical success (hemodynamic stabilization), procedure-related complications, and mortality were compared between the groups.ResultsAll EVAR procedures and embolizations were successful. The clinical success rates in the NBCA and control groups were 95% (21/22) and 71% (5/7), respectively (p=0.14). There was no complication related to the procedure. Type II endoleak occurred in 4 of 21 patients (19%) in the NBCA group vs none of the control patients. One patient (5%) died in the NBCA group vs 3 (43%) in the controls (p=0.034).ConclusionSac embolization using NBCA in emergency EVAR appears to be feasible and safe for ruptured AAA and IAA.

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