Preoperative Inferior Mesenteric Artery Embolization: A Valid Method to Reduce the Rate of Type II Endoleak after EVAR?

Manunga, Jesse; Cragg, Andrew H.; Garberich, Ross; Urbach, Jonathan A.; Skeik, Needa; Alexander, Jason Q.; Titus, Jessica; Stephenson, Elliot; Alden, Peter; Sullivan, Timothy M.

doi:10.1016/j.avsg.2016.05.106

Cited by 52 publications

(34 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…12 Kray et al 36 had also reported that a preoperatively patent IMA was associated with increased rates of type II endoleak and AAA sac expansion, suggesting that consideration should be given to preoperative occlusion of a patent IMA before EVAR. 36 In a recent study, Manunga et al 12 reported that preoperative embolization of the IMA protects against the development of type II endoleaks and secondary interventions and may potentially lead to a rapid aneurysmal sac regression. 12 In our study, only cases with IMA-related type II endoleak were included.…”

Section: Discussionmentioning

confidence: 99%

“…36 In a recent study, Manunga et al 12 reported that preoperative embolization of the IMA protects against the development of type II endoleaks and secondary interventions and may potentially lead to a rapid aneurysmal sac regression. 12 In our study, only cases with IMA-related type II endoleak were included. Results showed a high technical success rate and no signs of colon ischemia.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 Persistent flow from the IMA to the aneurysm sac after EVAR is present in 45% to 85% of all type II endoleaks. [10][11][12] Postoperative strategies to embolize the IMA and thereby to treat type II endoleaks have been described. Traditionally, the transarterial technique involves selective embolization of the IMA (through the middle colic artery).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Systematic review of laparoscopic ligation of inferior mesenteric artery for the treatment of type II endoleak after endovascular aortic aneurysm repair

Σπανός¹,

Tsilimparis²,

Larena‐Avellaneda³

et al. 2017

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Systematic review of laparoscopic ligation of inferior mesenteric artery for the treatment of type II endoleak after endovascular aortic aneurysm repair

Σπανός¹,

Tsilimparis²,

Larena‐Avellaneda³

et al. 2017

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…Intra-procedural embolization of IMA, LAs, and other sac branches prior to proper EVAR is necessary if their diameters are more than 2 mm [8,17,18]. Embolization of the accessory renal artery can inflict regional renal necrosis and a hypertension episode, therefore it must be evaluated individually to minimize patient risk.…”

Section: Prevention Of El2mentioning

confidence: 99%

Treatment of the Progressive Endoleak Type 2 After EVAR

Dobeš¹

2019

Abdominal Aortic Aneurysm - From Basic Research to Clinical Practice

View full text Add to dashboard Cite

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.

show abstract

“…Ward et al demonstrated that ancillary embolization of the IMA reduced the incidence of aneurysm sac enlargement, secondary procedures, and endoleak at 24 months post-EVAR (28). Likewise, a recent systematic review demonstrated the technical success of IMA embolization is high and may be warranted in patients with an IMA >3 mm in the prevention of type II endoleaks (29). On the other hand, a patent IMA with a severely stenotic SMA or occluded SMA may place the patient at increased risk for colonic ischemia and may be considered an anatomic contraindication to EVAR (19,20) (Figure 4).…”

Section: Imamentioning

confidence: 99%

Repair of abdominal aortic aneurysms: preoperative imaging and evaluation

Pisimisis

Sheth

2018

Cardiovasc. Diagn. Ther.

View full text Add to dashboard Cite

Imaging is a critical component of the pre-procedure evaluation and planning of endovascular aneurysm repair (EVAR). Imaging is the mainstay for proper assessment of procedural candidacy, relevant vascular anatomy, device selection, and surgical approach. Computed tomography angiography (CTA) has long been considered the preferred modality for pre-operative imaging and evaluation prior to EVAR.Recently, advances in image quality and software technology have further enhanced the proceduralist's ability to plan and perform EVAR. In this review, we highlight the current state of the art to provide interventionalists a contemporary assessment of the available tools for pre-operative imaging and evaluation prior to EVAR.

show abstract

Preoperative Inferior Mesenteric Artery Embolization: A Valid Method to Reduce the Rate of Type II Endoleak after EVAR?

Cited by 52 publications

References 33 publications

Systematic review of laparoscopic ligation of inferior mesenteric artery for the treatment of type II endoleak after endovascular aortic aneurysm repair

Systematic review of laparoscopic ligation of inferior mesenteric artery for the treatment of type II endoleak after endovascular aortic aneurysm repair

Treatment of the Progressive Endoleak Type 2 After EVAR

Repair of abdominal aortic aneurysms: preoperative imaging and evaluation

Contact Info

Product

Resources

About