case_images: PMC10839416_01
case_images: Contrast-enhanced CT before transarterial embolization for a type 2 endoleak.. (A) Axial arterial phase contrast-enhanced CT image of the lower thorax showing an endoleak (arrow).. (B) Anterior view of three-dimensional CT showing a type 2 endoleak (arrow) through the thoracodorsal artery (curved arrow) and the ninth intercostal artery (arrowhead).. CT: computed tomography
case_images: cureus-0016-00000051694-i01.jpg
case_images: PMC10839416_01_cureus-0016-00000051694-i01.jpg
case_images: FIG1
case_images: CT obtained one year prior. CT also revealed a T2EL through the right ninth intercostal artery (Figure 1).
case_images: Angiography of the thoracodorsal artery before transarterial embolization for a type 2 endoleak.. (A) Early arterial phase image showing a long and tortuous branch of the thoracodorsal artery (arrows) communicating with the ninth intercostal artery (arrowhead).. (B) Late arterial phase image showing a type 2 endoleak (arrow) from the ninth intercostal artery (arrowhead).
case_images: cureus-0016-00000051694-i02.jpg
case_images: PMC10839416_01_cureus-0016-00000051694-i02.jpg
case_images: FIG2
case_images: Angiography of the right thoracodorsal artery revealed a long and tortuous branch communicating with the right ninth intercostal artery and a T2EL through the intercostal artery (Figure 2).
case_images: Fluoroscopic image during transarterial embolization for a type 2 endoleak.. (A) Angiography of the 1.6-F microcatheter showing the tortuosity of the thoracodorsal artery branch. Note the tip positions of the 1.6-F microcatheter (white arrow), 2.6-F microcatheter (white arrowhead), and 4-F distal access catheter (black arrow). At that point, a 0.014-inch guidewire could not be advanced further because of the high friction between the guidewire and the 1.6-F microcatheter.. (B) After changing the 1.6-F microcatheter to a 1.3-F microcatheter, the catheters were successfully advanced using a 0.010-inch guidewire. Note the tip positions of the 1.3-F microcatheter (white arrow), 2.6-F microcatheter (white arrowhead), 4-F distal access catheter (black arrow), and 4-F guiding sheath (black arrowhead).
case_images: cureus-0016-00000051694-i03.jpg
case_images: PMC10839416_01_cureus-0016-00000051694-i03.jpg
case_images: FIG3
case_images: During the procedure, however, the guidewire could not be advanced further because of the high friction between the guidewire and the microcatheter due to the tortuosity of the vessel (Figure 3A). The inner diameter of the catheter was 0.011 inches. A 0.010-inch guidewire was advanced from the 1.3-F microcatheter, and the wire easily passed through the tortuous communicating artery. The 1.3-F and 2.6-F microcatheters and the 4-F distal access catheter were advanced deeply (Figure 3B).
case_images: Angiography from the 1.3-F microcatheter (arrow) shows the endoleak cavity (arrowhead).. No inflow or outflow vessels are observed.
case_images: cureus-0016-00000051694-i04.jpg
case_images: PMC10839416_01_cureus-0016-00000051694-i04.jpg
case_images: FIG4
case_images: Angiography of the thoracodorsal artery after transarterial embolization shows no visualization of a type 2 endoleak.. NBCA cast (arrow) is observed in the endoleak cavity and the ninth intercostal artery.. NBCA: n-butyl cyanoacrylate
case_images: cureus-0016-00000051694-i05.jpg
case_images: PMC10839416_01_cureus-0016-00000051694-i05.jpg
case_images: FIG5
case_images: Angiography of the right subscapular artery revealed endoleak occlusion (Figure 5).