Selective Inferior Mesenteric Artery Embolization during Endovascular Abdominal Aortic Aneurysm Repair to Prevent Type II Endoleak

Tetsuya Fukuda, Hitoshi Matsuda, Hiroshi Tanaka, Yoshihiro Sanda, Yoshiaki Morita, Yoshimasa Seike

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

PURPOSE: The purpose of this study was to evaluate the efficacy of simultaneous IMA (s-IMA) embolization during the endovascular abdominal aortic aneurysm repair (EVAR). MATERIALS AND METHOD: From July 2007 to January 2011, 189 patients in the no embolization (NE) group underwent EVAR without the indication for s-IMA embolization. Since February 2011 to April 2014, 143 patients have undergone EVAR. Among these patients, 26 patients underwent s-IMA embolism under a predefined indication and constituted the simultaneous embolization (SE) group. The indications for s-IMA embolization were defined by preoperative computed tomography (CT) findings, as follows: (1) the diameter was greater than 2.5 mm and (2) no stenosis due to thrombus or calcification at its orifice. RESULTS: The incidence of a type II endoleak from the IMA was 3.4% (5/143) in the SE group patients and 13.2% (25/189) in the NE group patients (p = 0.013), and the incidence of a type II endoleak from all branches (i.e., IMA, lumbar, medial sacral arteries) was 15.4% (22/143) in the SE group patients and 32.3% (61/189) in the NE group patients (p = 0.0003). During the follow-up period (range, 6-72 months; mean: 28 months), the reintervention rate for a type II endoleak from the IMA and/or other branches was 9.5% (18/189) in the NE group and 0.6% (1/143) in the SE group (p = 0.0001). CONCLUSION: In selected patients, performing an s-IMA embolization, based on CT findings, decreased the incidence of a type II endoleak and reintervention from the IMA and from all branches.

Original languageEnglish
Pages (from-to)E130-E135
JournalThe Kobe journal of medical sciences
Volume63
Issue number5
Publication statusPublished - 2018 Jul 3
Externally publishedYes

Keywords

  • coil embolization
  • endovascular aneurysm repair
  • inferior mesenteric artery
  • type II endoleak

ASJC Scopus subject areas

  • Medicine(all)

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