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DOI: 10.1055/s-0042-1742655
Inferior Mesenteric Artery Associated Type II Endoleaks: Are They Predictable?

Abstract
Purpose This study aims to evaluate the relationship between inferior mesenteric artery (IMA) diameter and risk of type II endoleak.
Subjects and Methods: A retrospective study design to review all EVARs performed over a 4-year period at a tertiary care center. Out of the total cohort of 400 patients who underwent EVAR, 41 patients (10.3%) developed type II endoleak. The mean IMA ostial diameter for patients with type II endoleak secondary to IMA contributories was 4mm, while the mean IMA diameter for patients with lumbar arteries contributing to the type II endoleak was 3.7mm.
Results Statistical analysis using a paired t-test did not show a statistically significant difference in the IMA ostial diameter between the two groups.
Conclusion There is no significant correlation between preprocedural IMA ostium diameter and type II endoleak development and hence, preprocedural IMA embolization is not an appropriate prophylactic management strategy.
Ethics Approval and Consent to Participate
Informed consent was obtained for the procedure. Institutional board approval was not required for this publication.
Consent for Publication
Patient's informed consent for the use of images and anonymous publication was obtained.
Competing Interests
The authors declare that they have no competing interests. This study was not supported by any funding.
Publication History
Article published online:
14 February 2022
© 2022. The Pan Arab Interventional Radiology Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Sampaio SM, Panneton JM, Mozes GI. et al. Aneurysm sac thrombus load predicts type II endoleaks after endovascular aneurysm repair. Ann Vasc Surg 2005; 19 (03) 302-309 https://pubmed.ncbi.nlm.nih.gov/15818458/ cited2020Nov17 [Internet]
- 2 Velazquez OC, Baum RA, Carpenter JP. et al. Relationship between preoperative patency of the inferior mesenteric artery and subsequent occurrence of type II endoleak in patients undergoing endovascular repair of abdominal aortic aneurysms. J Vasc Surg 2000; 32 (04) 777-788 http://www.jvascsurg.org/article/S0741521400502122/fulltext cited2020Nov17 [Internet]
- 3 Axelrod DJ, Lookstein RA, Guller J. et al. Inferior mesenteric artery embolization before endovascular aneurysm repair: technique and initial results. J Vasc Interv Radiol 2004; 15 (11) 1263-1267 http://www.jvir.org/article/S1051044307604783/fulltext cited2020Nov17 [Internet]
- 4 Ward TJ, Cohen S, Fischman AM. et al. Preoperative inferior mesenteric artery embolization before endovascular aneurysm repair: decreased incidence of type II endoleak and aneurysm sac enlargement with 24-month follow-up. J Vasc Interv Radiol 2013; 24 (01) 49-55 https://pubmed.ncbi.nlm.nih.gov/23273697/ cited2020Nov17 [Internet]
- 5 Nevala T, Biancari F, Manninen H. et al. Inferior mesenteric artery embolization before endovascular repair of an abdominal aortic aneurysm: effect on type II endoleak and aneurysm shrinkage. J Vasc Interv Radiol 2010; 21 (02) 181-185 https://pubmed.ncbi.nlm.nih.gov/20022764/ cited2020Nov17 [Internet]
- 6 Bonvini R, Alerci M, Antonucci F. et al. Preoperative embolization of collateral side branches: a valid means to reduce type II endoleaks after endovascular AAA repair. J Endovasc Ther 2003; 10 (02) 227-232 https://pubmed.ncbi.nlm.nih.gov/12877603/ cited2020Nov17 [Internet]
- 7 Dijkstra ML, Zeebregts CJ, Verhagen HJM. et al; ENGAGE investigators. Incidence, natural course, and outcome of type II endoleaks in infrarenal endovascular aneurysm repair based on the ENGAGE registry data. J Vasc Surg 2020; 71 (03) 780-789 https://pubmed.ncbi.nlm.nih.gov/31443976/ cited2021Feb14 [Internet]
- 8 Sidloff DA, Stather PW, Choke E, Bown MJ, Sayers RD. Type II endoleak after endovascular aneurysm repair. Br J Surg 2013; 100 (10) 1262-1270 http://doi.wiley.com/10.1002/bjs.9181 cited2021Feb14 [Internet]
- 9 Jones JE, Atkins MD, Brewster DC. et al. Persistent type 2 endoleak after endovascular repair of abdominal aortic aneurysm is associated with adverse late outcomes. J Vasc Surg 2007; 46 (01) 1-8
- 10 Marchiori A, von Ristow A, Guimaraes M, Schönholz C, Uflacker R. Predictive factors for the development of type II endoleaks. J Endovasc Ther 2011; 18 (03) 299-305 http://jet.sagepub.com/lookup/doi/10.1583/10-3116.1 cited2021Feb15 [Internet]
- 11 Muthu C, Maani J, Plank LD, Holden A, Hill A. Strategies to reduce the rate of type II endoleaks: routine intraoperative embolization of the inferior mesenteric artery and thrombin injection into the aneurysm sac. J Endovasc Ther 2007; 14 (05) 661-668 http://journals.sagepub.com/doi/10.1177/152660280701400509 cited2021Feb15 [Internet]
- 12 Brown A, Saggu GK, Bown MJ, Sayers RD, Sidloff DA. Type II endoleaks: challenges and solutions. Vascular health and risk management. Dove Med Press Ltd 2016; 12: 53-63
- 13 National Institute for Health and Care Excellence. Abdominal aortic aneurysm: diagnosis and management NICE guideline [Internet]. 2020 Mar [cited 2021 Feb 21]. Accessed January 12, 2022 from: www.nice.org.uk/guidance/ng156
- 14 Fukuda T, Matsuda H, Sanda Y. et al. CT findings of risk factors for persistent type II endoleak from inferior mesenteric artery to determine indicators of preoperative IMA embolization. Ann Vasc Dis 2014; 7 (03) 274-279
- 15 Otsu M, Ishizaka T, Watanabe M. et al. Analysis of anatomical risk factors for persistent type II endoleaks following endovascular abdominal aortic aneurysm repair using CT angiography. Surg Today 2016; 46 (01) 48-55 https://pubmed.ncbi.nlm.nih.gov/25578204/ cited2021Feb27 [Internet]
- 16 Güntner O, Zeman F, Wohlgemuth WA. et al. Inferior mesenteric arterial type II endoleaks after endovascular repair of abdominal aortic aneurysm: are they predictable?. Radiology 2014; 270 (03) 910-919 http://pubs.rsna.org/doi/10.1148/radiol.13130489 cited2021Feb27 [Internet]
- 17 Zhou W, Blay Jr E, Varu V. et al. Outcome and clinical significance of delayed endoleaks after endovascular aneurysm repair. J Vasc Surg 2014; 59 (04) 915-920 Available from https://pubmed.ncbi.nlm.nih.gov/24360584/ cited2021Feb27 [Internet]. Accessed January 12, 2022