Early Results of Shape Memory Polymer Embolization for Endoleak Treatment after Thoracoabdominal Fenestrated/Branched Endovascular Aneurysm Repair.

Authors

David P Kuwayama, Prashanth Vallabhajosyula, Cassius Iyad Ochoa Chaar, Sarah Loh, Jonathan Cardella, Roland Assi, Edouard Aboian, David Strosberg, Matthew Williams

Published in

Annals of vascular surgery. Oct 05, 2026. Epub Oct 05, 2026.

Abstract

Endoleaks after thoracoabdominal fenestrated/branched endovascular aneurysm repair (TA-F/BEVAR) may require multimodal treatment, including sac access and cavity filling. Shape memory polymer (SMP) is a self-expanding porous scaffold that promotes organized thrombus, is radiolucent, exerts low radial force, and biodegrades. We evaluated SMP embolization to fill endoleak cavities after TA-F/BEVAR.
Retrospective review of all patients treated at a single center with IMPEDE-FX Embolization Plugs for endoleak after TA-F/BEVAR (July 2024-June 2026). Outcomes were endoleak resolution, change in sac diameter and volume, complications, and endoleak-related reintervention.
Ten patients (8 male; median age 70) underwent 12 procedures. Median preoperative endoleak volume was 25 mL (range, 3-148 mL); 6 had prior endoleak-directed reintervention. A median 114 plugs were implanted per procedure (range, 29-297). No procedural complications occurred. At a median of 34 days, 5 patients (50%) had complete resolution, 3 (30%) near-complete resolution (residual 1.3-2.0 mL), and 2 (20%) partial resolution (residual 25-32 mL); both of the latter underwent a second SMP procedure achieving near-complete resolution. At last follow-up (median 155 days; range, 30-761 days) no new endoleaks were identified. Sacs regressed in 6 patients and were stable in 4; none expanded.
SMP embolization was safe and effective for significant endoleak after TA-F/BEVAR, despite large endoleak volumes and frequent prior failed intervention. All patients achieved substantial endoleak reduction or resolution; most sacs regressed and none expanded. Longer follow-up is needed to establish durability.

PMID:
42833586
Bibliographic data and abstract were imported from PubMed on 06 Oct 2026.

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