Type II Endoleak After Endovascular Aortic Aneurysm Repair Using the Endurant Stent Graft System for Abdominal Aortic Aneurysm with Occluded Inferior Mesenteric Artery

Journal Article · Mon Apr 15 04:00:00 EDT 2019 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-018-2140-8· OSTI ID:22953109

Gentsu, Tomoyuki; Okada, Takuya; Yamaguchi, Masato; Horinouchi, Hiroki; Katayama, Naoto; Ueshima, Eisuke; Koide, Yutaka; Sofue, Keitaro ^[1]; Gotake, Yasuko; Nomura, Yoshikatsu; Tanaka, Hiroshi; Okita, Yutaka ^[2]; Sugimoto, Koji; Murakami, Takamichi ^[1]

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1. Kobe University Graduate School of Medicine, Department of Radiology (Japan)
2. Kobe University Graduate School of Medicine, Division of Cardiovascular Surgery, Department of Surgery (Japan)

Purpose: To evaluate the incidence of type II endoleak (EL-II) and aneurysm enlargement after endovascular aneurysm repair (EVAR) using the Endurant stent graft in patients with abdominal aortic aneurysm (AAA) with occluded inferior mesenteric artery (IMA). Materials and Methods: Between 2012 and 2017, 103 patients who underwent EVAR using the Endurant stent graft for AAA with occluded IMA (50 patients with prophylactic embolized IMA and 53 with spontaneous occluded IMA) were retrospectively reviewed. The incidence of EL-II and aneurysm enlargement was evaluated. Predictive factors for persistent EL-II were evaluated based on patient characteristics, preprocedural anatomical characteristics, intraprocedural details, and postprocedural complications. Results: Incidence rates of early EL-II and persistent EL-II were 6.8% (7/103 patients) and 4.9% (5/103 patients), respectively. Aneurysm enlargement was found in 10 patients (9.7%), including all 5 patients with persistent EL-II, 3 with de novo EL-II, and 2 with no EL-II. The rates of freedom from aneurysm enlargement at 1, 2, and 3 years were 98.7%, 97.0%, and 93.1% for the group without persistent EL-II, and 80.0%, 60.0%, and 20.0% for the group with persistent EL-II (p < 0.001), respectively. The maximum aneurysm diameter (odds ratio (OR), 1.16; 95% confidence interval (CI), 1.01–1.34; p = 0.0362) and the number of patent lumbar arteries (OR, 2.72; 95% CI, 1.07–6.90; p = 0.0357) were predictive of persistent EL-II. Conclusions: The incidence of EL-II after EVAR using the Endurant stent graft for AAA with occluded IMA was low, but most early EL-II persisted and resulted in aneurysm enlargement. Level of Evidence Level 4, Case Series.

• OSTI ID: 22953109
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 4 Vol. 42; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

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