Identification of Anatomical Risk Factors for Type II Endoleak to Guide Selective Inferior Mesenteric Artery Embolization

Samura, Makoto; Morikage, Noriyasu; Mizoguchi, Takahiro; Takeuchi, Yuriko; Ueda, Koshiro; Harada, Takasuke; Yamashita, Osamu; Suehiro, Kotaro; Hamano, Kimikazu

doi:10.1016/j.avsg.2017.10.016

Cited by 41 publications

(24 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since preoperative anatomical features represent risk factors for T2EL development, 111,112 several authors have proposed prophylactic embolization of the IMA 113e115 or of the sac 116 to reduce the incidence of T2ELs and related complications. Prophylactic management can be performed prior to EVAR (preoperatively) 117 or during EVAR (intraoperatively). 118e120 Even if preventive interventions have been shown to cause a reduction in the incidence of T2ELs, whether the decreased rate of T2ELs actually translates in clinical benefits remains controversial.…”

Section: Preventionmentioning

confidence: 99%

Natural History, Diagnosis, and Management of Type II Endoleaks after Endovascular Aortic Repair: Review and Update

D’Oria

Mastrorilli

Ziani

2020

Annals of Vascular Surgery

View full text Add to dashboard Cite

Section: Preventionmentioning

confidence: 99%

Natural History, Diagnosis, and Management of Type II Endoleaks after Endovascular Aortic Repair: Review and Update

D’Oria

Mastrorilli

Ziani

2020

Annals of Vascular Surgery

View full text Add to dashboard Cite

“…Accordingly, multiple vascular centres have investigated anatomical risk factors of persistent type II EL and introduced a pre-emptive embolisation of IMA protocol during EVAR for high-risk patients. The anatomical risk factors for developing persistent type II EL include patent IMA, higher number of patent lumber arteries and the diameter of IMA and lumber artery 8 21–23. Regarding the diameter of IMA, patients whose diameter of IMA ≥2.5 mm will be recruited to this study as Fukuda et al demonstrated the highest diagnostic performance to predict persistent type II EL occurred when a 2.5 mm threshold was chosen 8.…”

Section: Discussionmentioning

confidence: 99%

Multicentre randomised controlled trial to evaluate the efficacy of pre-emptive inferior mesenteric artery embolisation during endovascular aortic aneurysm repair on aneurysm sac change: protocol of Clarify IMA study

et al. 2020

View full text Add to dashboard Cite

IntroductionType II endoleak (EL) is frequently seen after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) and is often considered responsible for aneurysm sac enlargement if it persists. In order to reduce type II EL and consequent sac enlargement, pre-emptive embolisation of the inferior mesenteric artery (IMA), which is a main source for persistent type II EL, has been introduced in many vascular centres. At present, there is a lack of robust evidence to support the efficacy of pre-emptive embolisation of IMA on reduction of persistent type II EL with subsequent sac shrinkage.Method and analysisThis multicentre, randomised controlled trial will recruit 200 patients who have fusiform AAA ≥50 mm/rapidly enlarging fusiform AAA, with patent IMA, and randomly allocate them either to a pre-emptive IMA embolisation group or non-embolisation control group in a ratio of 1:1. The primary endpoint is the difference of aneurysm sac volume change assessed by CT scans between the pre-emptive IMA embolisation group and the control group at 12 months after EVAR. The secondary endpoints are defined as change of aneurysm sac volume in both groups at 6 and 24 months, freedom from sac enlargement at 12 and 24 months after EVAR, prevalence of type II EL at 1, 6, 12 and 24 months evaluated by contrast-enhanced CT, reintervention rate, aneurysm related mortality, overall survival, perioperative morbidity, volume of contrast media used during EVAR and dosage of radiation.Ethics and disseminationThe protocol has been reviewed and approved by the ethics committee of Nara Medical University (No. 2113). The findings of this study will be communicated to healthcare professionals, participants and the public through peer-reviewed publications, scientific conferences and the University Hospital Medical Information Network Clinical Trials Registry home page.Trial registration numberUMIN000035502.

show abstract

“…Gore and Associates, Flagstaff, AZ), and Endurant stent grafts ranged from 12.2 -23% [13,31], 23.5 -40% [31,32], and 9.1 -16.3% [15 -19], respectively. The differences of mechanical properties or fabric porosity of fabric may affect the intra-aneurysm pressure after EVAR and the incidence of EL-II [12,26]. However, there have been little studies regarding this mechanism.…”

Section: Discussionmentioning

confidence: 99%

Type II Endoleak After Endovascular Aortic Aneurysm Repair Using the Endurant Stent Graft System for Abdominal Aortic Aneurysm with Occluded Inferior Mesenteric Artery

Gentsu

Okada

Yamaguchi

et al. 2018

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

To evaluate the incidence of type II endoleak (EL-II) and aneurysm enlargement after endovascular aneurysm repair (EVAR) using the Endurant stent graft in patients with abdominal aortic aneurysm (AAA) with occluded inferior mesenteric artery (IMA). Materials and methods Between 2012 and 2017, 103 patients who underwent EVAR using the Endurant stent graft for AAA with occluded IMA (50 patients with prophylactic embolized IMA and 53 with spontaneous occluded IMA) were retrospectively reviewed. The incidence of EL-II and aneurysm enlargement was evaluated. Predictive factors for persistent EL-II were also evaluated based on patient characteristics, preprocedural anatomical characteristics, and intraprocedural details and postprocedural complications. 2 2 Results Incidence rates of early EL-II and persistent EL-II were 6.8% (7 / 103 patients) and 4.9% (5 / 103 patients), respectively. Aneurysm enlargement was found in 10 patients (9.7%), including all 5 patients with persistent EL-II, 3 with de-novo EL-II, and 2 with no EL-II. The rates of freedom from aneurysm enlargement at 1, 2, and 3 years were 98.7%, 97.0%, and 93.1% for the group without persistent EL-II, and 80.0%, 60.0%, and 20.0% for the group with persistent EL-II (p <0.001), respectively. The maximum aneurysm diameter

show abstract

Identification of Anatomical Risk Factors for Type II Endoleak to Guide Selective Inferior Mesenteric Artery Embolization

Abstract: Patients with these risk factors are the candidates for undergoing treatment of preoperative IMA occlusion to reduce ELII.

Cited by 41 publications

References 25 publications

Natural History, Diagnosis, and Management of Type II Endoleaks after Endovascular Aortic Repair: Review and Update

Natural History, Diagnosis, and Management of Type II Endoleaks after Endovascular Aortic Repair: Review and Update

Multicentre randomised controlled trial to evaluate the efficacy of pre-emptive inferior mesenteric artery embolisation during endovascular aortic aneurysm repair on aneurysm sac change: protocol of Clarify IMA study

Type II Endoleak After Endovascular Aortic Aneurysm Repair Using the Endurant Stent Graft System for Abdominal Aortic Aneurysm with Occluded Inferior Mesenteric Artery

Contact Info

Product

Resources

About