Single-Center Evaluation of Inferior Mesenteric Arterial Type II Endoleaks in Patient Undergoing Endovascular Aortic Aneurysm Repair for Infrarenal Abdominal Aortic Aneurysm

Objectives: To evaluate the association of inferior mesenteric arterial (IMA) type II endoleaks in patients undergoing endovascular aortic aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm at our tertiary center. Methods: This was a retrospective single tertiary center evaluation study of all EVARs performed over 4 years (2014–2018). Information for analysis was gathered using RIS/PACS and ICE clinical systems. Imaging data included change in aneurysm sac size poststent-graft insertion, percentage of type of II endoleaks, causative vessels identified contributing to the endoleaks, patency, and ostial diameters of IMA prestent-graft insertion. Results: Four hundred patients underwent EVAR in 4 years. 10% (41) had type II endoleaks postprocedure. Of the type II endoleaks, 88% (36%) had a patent IMA in the pre-procedural computed tomography. The type II endoleaks were further subdivided into three groups – Group A: IMA with or without lumbar arteries (n = 14, mean IMA ostial diameter of 4.0 mm), Group B: lumbar artery (n = 18, mean IMA ostial diameter 3.7 mm), Group C: unspecified (n = 4, mean IMA ostial diameter 2.7 mm). 21% (3) had IMA embolized and 7% (1) had open repair due to sac size increase. No statistically significant difference was seen in the IMA ostial size between Groups A and B (P = 0.6). Conclusion: Our study demonstrates a higher incidence of type II endoleaks in patients with patent IMA and lumbar arteries pre-EVAR. However, in our cohort, the diameter of the IMA did not influence the development of IMA type II endoleaks.

 

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Artikel online veröffentlicht:
26. April 2021