Percutaneous interventions following endovascular aneurysm sac sealing: Endoleak embolization and limb-related adverse events

The Nellix endovascular aneurysm sealing system is a novel alternative to conventional endovascular aneurysm repair for aortic aneurysm management using paired balloon-expandable endografts supported by polymer-filled endobags to achieve sealing and anatomic fixation. Part of the promise of endovascular aneurysm sealing is increased resistance to lateral and longitudinal forces and a potential for reduced rates of device-related failures, particularly endoleaks. Initial efficacy data on this device are encouraging, but our knowledge of its associated complications and their management is limited. Reported adverse events include Type I and II endoleaks, graft stenosis, and occlusion. The aim of this article was to review the early experience of endovascular aneurysm sealing, focusing on the incidence, significance, and management of device-related complications.