Coil embolisation improves EVAR results for high risk patients


Coil embolisation for at-risk patients during endovascular aneurysm repair (EVAR) is a safe and reproducible procedure, Dominique Fabre (Le Plessis-Robinson, France) told delegates at the 2019 Charing Cross Symposium (CX; 15–18 April, London, UK).

Fabre presented the results of the prospective, dual centre, randomised, comparative and open SCOPE 1 (sac embolisation per EVAR) study, for which he is the principal investigator, concluding that the procedure was statistically effective in terms of decreasing the number of endoleaks at one and six months.

The study investigators set out to compare the effect of coil embolisation when added to EVAR, splitting 91 patients into two groups: those treated with EVAR alone (45 patients), and those treated with EVAR and coils (46 patients).

No complications, spinal cord ischaemia, colonic ischaemia or migration were observed in either group, and Fabre reported a 100% success rate. For all time points (one, six, 12 and 24 months), the number of endoleaks was lower in the cohort treated with EVAR and coils than those treated with EVAR alone, leading the triallists to conclude that freedom from endoleak was significantly improved by the addition of coil embolisation. The total number of reinterventions was also lower with coil embolisation: 10% compared to 18%.

Fabre advises delegates that coil embolisation for high risk patients must be discussed for each EVAR case “to improve the post-operative and mid-term results”.


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