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

Omaida C Velazquez, Richard A. Baum, Jeffrey P. Carpenter, Michael A. Golden, Michael Cohn, Ann Pyeron, Clyde F. Barker, Frank J. Criado, Ronald M. Fairman

Research output: Contribution to journalArticle

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Abstract

Objectives: The purpose of this study was (1) to find out whether preoperative inferior mesenteric artery (IMA) patency (on radiographic imaging) predicts IMA-related endoleaks after endovascular repair of infrarenal abdominal aortic aneurysms, (2) to determine feasibility of measuring aneurysm sac pressures in patients with endoleaks, and (3) to report early evidence of effective endovascular obliteration of IMA endoleaks. Methods: We studied 76 consecutive cases of infrarenal aortic aneurysms that were repaired with an endovascular approach (March 1998-April 1999). Results: There were 13 (17%) endoleaks persistent 30 days after the procedure. Eleven (85%) of these 13 were IMA-related endoleaks, which were documented with selective superior mesenteric artery angiography. The preoperative finding (on computed tomographic scan) of a patent IMA does not always predict an IMA-related endoleak, but results in a statistically and clinically significant higher ratio of patients with IMA-related endoleaks in the immediate postoperative period (24% versus 3%, P < .035). In eight of the 11 patients with persistent IMA-related endoleaks, measurement of intraaneurysm sac pressures was possible, and six of these patients had systemic pressures within the excluded aneurysm sac. Nine (82%) of 11 IMA-related endoleaks were successfully obliterated by means of selective IMA embolization. Conclusions: Many endoleaks are caused by a patent IMA, and this can result in persistence of systemic pressure within the aneurysm sac. The preoperative finding (on computed tomographic scan) of a patent IMA is a predictor of increased rates of IMA endoleaks, and IMA endoleaks can be successfully obliterated through endovascular procedures, after endovascular abdominal aortic aneurysm repair.

Original languageEnglish
Pages (from-to)777-788
Number of pages12
JournalJournal of Vascular Surgery
Volume32
Issue number4
DOIs
StatePublished - Nov 7 2000
Externally publishedYes

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Inferior Mesenteric Artery
Endoleak
Abdominal Aortic Aneurysm
Aneurysm
Pressure
Endovascular Procedures
Superior Mesenteric Artery
Aortic Aneurysm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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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. / Velazquez, Omaida C; Baum, Richard A.; Carpenter, Jeffrey P.; Golden, Michael A.; Cohn, Michael; Pyeron, Ann; Barker, Clyde F.; Criado, Frank J.; Fairman, Ronald M.

In: Journal of Vascular Surgery, Vol. 32, No. 4, 07.11.2000, p. 777-788.

Research output: Contribution to journalArticle

Velazquez, Omaida C ; Baum, Richard A. ; Carpenter, Jeffrey P. ; Golden, Michael A. ; Cohn, Michael ; Pyeron, Ann ; Barker, Clyde F. ; Criado, Frank J. ; Fairman, Ronald M. / 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. In: Journal of Vascular Surgery. 2000 ; Vol. 32, No. 4. pp. 777-788.
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title = "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",
abstract = "Objectives: The purpose of this study was (1) to find out whether preoperative inferior mesenteric artery (IMA) patency (on radiographic imaging) predicts IMA-related endoleaks after endovascular repair of infrarenal abdominal aortic aneurysms, (2) to determine feasibility of measuring aneurysm sac pressures in patients with endoleaks, and (3) to report early evidence of effective endovascular obliteration of IMA endoleaks. Methods: We studied 76 consecutive cases of infrarenal aortic aneurysms that were repaired with an endovascular approach (March 1998-April 1999). Results: There were 13 (17{\%}) endoleaks persistent 30 days after the procedure. Eleven (85{\%}) of these 13 were IMA-related endoleaks, which were documented with selective superior mesenteric artery angiography. The preoperative finding (on computed tomographic scan) of a patent IMA does not always predict an IMA-related endoleak, but results in a statistically and clinically significant higher ratio of patients with IMA-related endoleaks in the immediate postoperative period (24{\%} versus 3{\%}, P < .035). In eight of the 11 patients with persistent IMA-related endoleaks, measurement of intraaneurysm sac pressures was possible, and six of these patients had systemic pressures within the excluded aneurysm sac. Nine (82{\%}) of 11 IMA-related endoleaks were successfully obliterated by means of selective IMA embolization. Conclusions: Many endoleaks are caused by a patent IMA, and this can result in persistence of systemic pressure within the aneurysm sac. The preoperative finding (on computed tomographic scan) of a patent IMA is a predictor of increased rates of IMA endoleaks, and IMA endoleaks can be successfully obliterated through endovascular procedures, after endovascular abdominal aortic aneurysm repair.",
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T1 - 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

AU - Velazquez, Omaida C

AU - Baum, Richard A.

AU - Carpenter, Jeffrey P.

AU - Golden, Michael A.

AU - Cohn, Michael

AU - Pyeron, Ann

AU - Barker, Clyde F.

AU - Criado, Frank J.

AU - Fairman, Ronald M.

PY - 2000/11/7

Y1 - 2000/11/7

N2 - Objectives: The purpose of this study was (1) to find out whether preoperative inferior mesenteric artery (IMA) patency (on radiographic imaging) predicts IMA-related endoleaks after endovascular repair of infrarenal abdominal aortic aneurysms, (2) to determine feasibility of measuring aneurysm sac pressures in patients with endoleaks, and (3) to report early evidence of effective endovascular obliteration of IMA endoleaks. Methods: We studied 76 consecutive cases of infrarenal aortic aneurysms that were repaired with an endovascular approach (March 1998-April 1999). Results: There were 13 (17%) endoleaks persistent 30 days after the procedure. Eleven (85%) of these 13 were IMA-related endoleaks, which were documented with selective superior mesenteric artery angiography. The preoperative finding (on computed tomographic scan) of a patent IMA does not always predict an IMA-related endoleak, but results in a statistically and clinically significant higher ratio of patients with IMA-related endoleaks in the immediate postoperative period (24% versus 3%, P < .035). In eight of the 11 patients with persistent IMA-related endoleaks, measurement of intraaneurysm sac pressures was possible, and six of these patients had systemic pressures within the excluded aneurysm sac. Nine (82%) of 11 IMA-related endoleaks were successfully obliterated by means of selective IMA embolization. Conclusions: Many endoleaks are caused by a patent IMA, and this can result in persistence of systemic pressure within the aneurysm sac. The preoperative finding (on computed tomographic scan) of a patent IMA is a predictor of increased rates of IMA endoleaks, and IMA endoleaks can be successfully obliterated through endovascular procedures, after endovascular abdominal aortic aneurysm repair.

AB - Objectives: The purpose of this study was (1) to find out whether preoperative inferior mesenteric artery (IMA) patency (on radiographic imaging) predicts IMA-related endoleaks after endovascular repair of infrarenal abdominal aortic aneurysms, (2) to determine feasibility of measuring aneurysm sac pressures in patients with endoleaks, and (3) to report early evidence of effective endovascular obliteration of IMA endoleaks. Methods: We studied 76 consecutive cases of infrarenal aortic aneurysms that were repaired with an endovascular approach (March 1998-April 1999). Results: There were 13 (17%) endoleaks persistent 30 days after the procedure. Eleven (85%) of these 13 were IMA-related endoleaks, which were documented with selective superior mesenteric artery angiography. The preoperative finding (on computed tomographic scan) of a patent IMA does not always predict an IMA-related endoleak, but results in a statistically and clinically significant higher ratio of patients with IMA-related endoleaks in the immediate postoperative period (24% versus 3%, P < .035). In eight of the 11 patients with persistent IMA-related endoleaks, measurement of intraaneurysm sac pressures was possible, and six of these patients had systemic pressures within the excluded aneurysm sac. Nine (82%) of 11 IMA-related endoleaks were successfully obliterated by means of selective IMA embolization. Conclusions: Many endoleaks are caused by a patent IMA, and this can result in persistence of systemic pressure within the aneurysm sac. The preoperative finding (on computed tomographic scan) of a patent IMA is a predictor of increased rates of IMA endoleaks, and IMA endoleaks can be successfully obliterated through endovascular procedures, after endovascular abdominal aortic aneurysm repair.

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