Laparoscopic ligation of Type II endoleaks following endovascular aneurysm repair: A systematic review

Wee, Ian Jun Yan; Marjot, Thomas; Patel, Kaushik M.; Bhrugubanda, Vamsee; Choong, Andrew M.T.L.

doi:10.1177/1708538118773611

Cited by 16 publications

(17 citation statements)

References 71 publications

(130 reference statements)

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“…107 Also, laparoscopic intervention for the treatment of T2ELs has not gained wide recognition so far probably because only a few vascular surgeons are trained to undertake this procedure, and thus collaboration with a general surgeon may be needed. 108 Open conversion for T2ELs may be reasonably safe under elective circumstances, especially with endograft-preserving techniques. 109 Nevertheless, it arguably remains more invasive than any endovascular approach and typically less desirable given the significant medical comorbidities of patients selected for EVAR.…”

Section: Non-embolization Techniquesmentioning

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

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Section: Non-embolization Techniquesmentioning

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

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“…No systematic reviews have directly compared endovascular interventions with open/laparoscopic treatments, although several systematic reviews of surgical approaches have been reported [44,45]. In these reviews, high technical success rates of 90% and 30-day mortality rates of 1.5% or 0% were reported.…”

Section: Surgical Interventionmentioning

confidence: 99%

Recent Update of Endovascular Type 2 Endoleak Management

Katada

2020

Interventional Radiology

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EVAR has been used clinically for almost three decades, and it has been widely applied in clinical practice and has been applied to difficult cases as devices and techniques have evolved. Although the major advantage of EVAR is its lower perioperative mortality, compared with open surgery, late-onset complications such as endoleaks have become major issues, requiring lifelong follow-up after EVAR. The clinical guidelines have been updated, and many systematic reviews/meta-analyses and multi-center registries have been published; surgeons must keep up-to-date regarding these changes. In this review, the author reviews evidence on the recent update of the type 2 endoleak management.

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“…This approach allows us to clip the IMA close to the sac and an initial CTA should guide us to the reachable segment of the IMA to avoid duodenum injury. Thanks to a camera (angulated optic) the laparoscopic procedure allows very good visibility of the LAs for clipping [32,33]. The left side of the aorta and aneurysm is easily approached but the right side is difficult to access due to the tight, adherent position of the inferior vena cava.…”

Section: Laparoscopic Treatmentmentioning

confidence: 99%

“…Only deflation and inflation of the operation space is time consuming, especially when the scan has to be repeated a few times. The main risk to endoscopic treatment involves peritoneal and retroperitoneal bleeding but the incidence is small [32,33].…”

Section: Laparoscopic Treatmentmentioning

confidence: 99%

Treatment of the Progressive Endoleak Type 2 After EVAR

Dobeš¹

2019

Abdominal Aortic Aneurysm - From Basic Research to Clinical Practice

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An endoleak type 2 (EL2) is a relatively frequent event after an EVAR but 30-35% of EL2 can become progressive, which can cause a loss in the important sealing zone of the stent graft. Diagnosis is made by three-phase CT angiogram or by contrast-enhanced duplex scan. EL2 should be treated if the aortic sac grows more than 5 mm in 6 months time. The first suitable treatment is the endovascular approach with embolization of the inferior mesenteric artery (IMA) or lumbar arteries. Paravertebral puncture, under CT navigation to embolize the lumbar artery or a part of the aortic sac with the EL2, is another alternative. If the endovascular treatment is not successful in 2-3 times, we should consider a surgical approach. The operative approach can be a laparoscopic or an open operation: the laparoscopic approach allows us to clip the IMA and lumbar arteries. The open surgery involves laparotomy, ligation of the IMA, and endoaneurysmorrhaphy (suture of lumbar artery origins from inside) and then the suture of the aortic sac tightly around the stent graft in situ. The aortic occlusion balloon should be inserted below the renal arteries prior to open surgery. The surgical procedures have good outcomes and should be considered when the endovascular treatment is unsuccessful.

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Laparoscopic ligation of Type II endoleaks following endovascular aneurysm repair: A systematic review

Abstract: Laparoscopic ligation of feeding vessels causing Type II endoleak is potentially an alternative treatment after failed standard endovascular embolization, particularly in select centres with necessary resources and capabilities.

Cited by 16 publications

References 71 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

Recent Update of Endovascular Type 2 Endoleak Management

Treatment of the Progressive Endoleak Type 2 After EVAR

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