Embolization of the inferior mesenteric artery and lumbar arteries during endovascular aortic repair for the prevention of type Ⅱ endoleak:clinical significance and research progress
10.7659/j.issn.1005-6947.2024.12.013
- VernacularTitle:腹主动脉瘤腔内修复术中栓塞肠系膜下动脉和腰动脉预防Ⅱ型内漏的临床意义及研究进展
- Author:
Chengpeng TAN
1
;
Dan RONG
;
Hao LIU
;
Zihan ZHANG
;
Jian HE
;
Peng JIANG
;
Yongpan CUI
;
Fei MEI
Author Information
1. 三峡大学第一临床医学院(湖北省宜昌市中心人民医院) 血管外科,湖北宜昌 443003
- Publication Type:Journal Article
- Keywords:
Aortic Aneurysm,Abdominal;
Endovascular Procedures;
Endoleak;
Embolization,Therapeutic
- From:
Chinese Journal of General Surgery
2024;33(12):2051-2057
- CountryChina
- Language:Chinese
-
Abstract:
Abdominal aortic aneurysm (AAA) is a type of aneurysmal aortic disease with a high mortality rate. Endovascular aneurysm repair (EVAR) is an effective treatment for this condition,but endoleaks can occur intraoperatively or years after the procedure,necessitating lifelong monitoring. Type Ⅱ endoleak (T2EL) is a major complication of EVAR,primarily caused by persistent retrograde perfusion of the aneurysm sac from collateral vessels such as the inferior mesenteric artery (IMA) and lumbar arteries (LA). The occurrence of T2EL is closely related to patient anatomical factors (e.g.,the diameter,number,and patency of collateral vessels),surgical factors (e.g.,the degree of stent graft adherence to the arterial wall),and systemic factors such as hypertension. Persistent T2EL may lead to aneurysm sac enlargement and increased risk of rupture,thereby adversely affecting patient prognosis. In recent years,prophylactic embolization of the IMA and LA has shown certain advantages in reducing the incidence of T2EL,aneurysm sac enlargement,and reintervention rates,contributing positively to improving treatment outcomes and quality of life of the patients. Here,the authors reviewed literature published between January 2002 and July 2024 on the epidemiology of endoleaks following EVAR and the use of IMA and LA embolization during EVAR to prevent T2EL. The current research was summarized to discuss the clinical value of prophylactic IMA and LA embolization in patients at high risk of T2EL.
