Analysis and discussion of prophylactic embolization of inferior mesenteric artery and lumbar artery in endovascular abdominal aortic aneurysm repair
10.7659/j.issn.1005-6947.2024.12.014
- VernacularTitle:关于腹主动脉瘤腔内修复术中预防性栓塞肠系膜下动脉和腰动脉的分析与探讨
- Author:
Qiang GUO
1
;
Xiaoxi SHI
;
Kun FANG
;
Zhihui DONG
;
Yi YANG
;
Jichun ZHAO
;
Chang SHU
;
Xin LI
Author Information
1. 四川大学华西医院血管外科,四川成都 610041
- Publication Type:Journal Article
- Keywords:
Aortic Aneurysm,Abdominal;
Endoleak;
Embolization,Therapeutic
- From:
Chinese Journal of General Surgery
2024;33(12):2058-2061
- CountryChina
- Language:Chinese
-
Abstract:
Endovascular aneurysm repair (EVAR) is a key treatment for abdominal aortic aneurysms (AAA),but type Ⅱ endoleak (T2EL) is one of the most common postoperative complications. T2EL mainly arises from retrograde blood flow from collateral vessels such as the inferior mesenteric artery (IMA) and lumbar arteries (LA),which continue to perfuse the aneurysm sac. Although T2EL may lead to aneurysm sac enlargement or even rupture,its overall clinical impact is relatively minor,and most cases can be effectively managed through observation or minimally invasive interventions. Currently,the efficacy of prophylactic embolization of the IMA and LA in reducing the incidence of T2EL remains uncertain and may increase operative time,radiation exposure,and the risk of associated complications. More importantly,authoritative guidelines,both domestic and international,do not recommend routine prophylactic embolization of the IMA and LA during EVAR. Whether prophylactic embolization should be performed in high-risk patients for T2EL remains controversial,with most studies in this area being small-sample or single-center retrospective analyses,offering limited evidence quality. This article analyzes the harm of T2EL,the effectiveness of prophylactic embolization,and relevant guideline recommendations based on existing research,aiming to provide a reference for the individualized management of T2EL following EVAR.
