Inferior Mesenteric Artery Embolization Reduced the Incidence of Persistent Type 2 Endoleak and Related Reintervention After EVAR Without Promoting Aneurysm Shrinkage

Xiang, Yuwei; Huang, Bin

doi:10.1177/15266028221091887

Cited by 1 publication

(2 citation statements)

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“…Pre-embolization for the IMA or aneurysm sac in high-risk patients seems to be of greater benefit ( 14 , 47 , 48 ), and it could suppress aneurysm sac expansion and reduce the reintervention rate. A network meta-analysis ( 49 ) suggested that IMA embolization demonstrated benefits in achieving long-term aneurysm sac stability and lowering the risk of secondary surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Although our study did not find a statistical correlation between ILA and T2ELs, T2ELs caused by ILA still deserve attention. Pre-embolization for the IMA or aneurysm sac in high-risk patients seems to be of greater benefit (14,47,48), and it could suppress aneurysm sac expansion and reduce the reintervention rate. A network meta-analysis (49) suggested that IMA embolization demonstrated benefits in achieving long-term However, Kontopodis et al (50) in their meta-analysis that included four random studies, suggested that preemptive embolization confers no clinical benefits in EVAR, but their data were limited and had low certainty.…”

Section: Discussionmentioning

confidence: 99%

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Patent iliolumbar artery increase no risk of type II endoleaks after endovascular abdominal aortic aneurysm: a case-control study

Chen,

Liu,

Weng

et al. 2023

Front. Cardiovasc. Med.

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ObjectiveThe aims of the present study were to explore the risk factors for type 2 endoleaks (T2ELs) after endovascular aneurysm repair (EVAR) and the association between T2ELs and the iliolumbar artery.Materials and methodsA single-center, retrospective case–control study in West China Hospital was conducted among patients with infrarenal abdominal aortic aneurysm (AAA) who underwent EVAR between June 2010 and June 2019. The associations of patient characteristics, anatomical factors, internal iliac artery embolization, and ILA with the primary outcome were analyzed. The secondary objective was to analyze survival and reintervention between the T2EL group and the non-T2EL group. Kaplan–Meier survival, propensity matching analysis and multivariate logistic regression analysis were used.ResultsA total of 603 patients were included. The median follow-up was 51 months (range 5.0–106.0). There was a significant difference in the diameter of the lumbar artery (LA), middle sacral artery (MSA) and inferior mesentery artery (IMA), proportion of thrombus and LA numbers. The univariate analysis showed that T2ELs were more likely to develop more thrombus in aneurysm cavity (OR = 0.294, p = 0.012), larger MSA (OR = 1.284, p = 0.04), LA (OR = 1.520, p = 0.015), IMA (OR = 1.056, p < 0.001) and more LAs (OR = 1.390, p = 0.019). The multivariate analysis showed that the number of LAs (HR: 1.349, 95% CI: 1.140–1.595, p < .001) and the diameter of the IMA (HR: 1.328, 95% CI: 1.078–1.636, p = 0.008) were significantly associated with T2ELs. There were no new findings from the propensity score matching. The reintervention-free survival rates were significantly different between the two groups (p = 0.048). Overall survival and AAA-related death rates were not different between the two group. This was consistent with the PSM analysis.ConclusionThe iliolumbar artery and the different internal iliac artery interventions may not increase the incidence of T2ELs. But the numbers of LAs and IMA diameter were independent risk factors for T2Els. T2ELs was associated with the reintervention but did not affect long-term survival or increase aneurysm-related mortality after EVAR.

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