The Use of Technetium-99m-Labeled Human Serum Albumin Diethylenetriamine Pentaacetic Acid Single-Photon Emission CT Scan in the Follow-up of Type II Endoleak Treatment

An 84-year-old woman presented with persistent type II endoleak with sac expansion from 57 mm to 75 mm during 4-year follow-up after endovascular abdominal aortic aneurysm repair. The patient underwent transabdominal embolization with coils and N-butyl cyanoacrylate/ethiodized oil (Lipiodol; Guerbet, Villepinte, France) mixture (2.5 mL). Because of the anticipated embolization artifacts on follow-up computed tomography (CT), technetium-99m-labeled human serum albumin diethylenetriamine pentaacetic acid single-photon emission computed tomography (99mTc-HSAD SPECT) was performed before and after the intervention. Perigraft accumulation on 99mTc-HSAD SPECT corresponding to the endoleak disappeared after embolization. CT scan performed 12 months after embolization showed no signs of sac expansion. 99mTc-HSAD SPECT may be useful for evaluating therapeutic effect after embolization for endoleak.