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Systematic review of laparoscopic ligation of inferior mesenteric artery for the treatment of type II endoleak after endovascular aortic aneurysm repair
- Source :
- Journal of vascular surgery. 66(6)
- Publication Year :
- 2017
-
Abstract
- Objective Type II endoleak after endovascular aneurysm repair (EVAR) is frequently caused by persistent flow from the inferior mesenteric artery (IMA). The aim of this study was to assess the perioperative and midterm efficacy of laparoscopic ligation of the IMA for treatment of endoleak. Methods MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane databases and key references were searched with Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology for studies reporting on laparoscopic ligation of the IMA for treatment of type II endoleak after EVAR. Results Eight case studies and one study of a retrospective nature were identified. In total, 20 patients (18 men; mean age, 73.6 ± 2 years; with a mean abdominal aortic aneurysm diameter of 64.3 ± 10 mm) who underwent post-EVAR laparoscopic ligation of the IMA for type II endoleak were analyzed. The mean time from EVAR until intervention ranged from 6 to 18 months. All but one patient were asymptomatic; in 9, the aneurysm sac was enlarged, and in 11, the endoleak was considered persistent without sac enlargement. The mean procedural duration was 99 ± 24 minutes, with technical success rate of 90% (18/20); in two cases, the patients were successfully reoperated on laparoscopically in 24 hours. The mean hospitalization was 3.6 ± 1.2 days, with 0% (0/20) perioperative and 30-day mortality. No patient underwent open conversion or showed signs of intestinal ischemia. During follow-up of 32.6 ± 12 months, 13 of 20 patients had aneurysm sac regression, whereas the rest had a stable sac diameter without evidence of persistent type II endoleak. Conclusions Laparoscopic ligation of the IMA for treatment of type II endoleak after EVAR is a feasible and safe technique in specialized centers with high technical success rate and good midterm outcomes.
- Subjects :
- Male
medicine.medical_specialty
Endoleak
medicine.medical_treatment
030204 cardiovascular system & hematology
030230 surgery
Endovascular aneurysm repair
Inferior mesenteric artery
03 medical and health sciences
Aortic aneurysm
Blood Vessel Prosthesis Implantation
0302 clinical medicine
Aneurysm
medicine.artery
medicine
Humans
Splanchnic Circulation
Ligation
Aged
Aged, 80 and over
business.industry
Endovascular Procedures
Mesenteric Artery, Inferior
Perioperative
Middle Aged
medicine.disease
Abdominal aortic aneurysm
Surgery
Treatment Outcome
Female
Laparoscopy
Radiology
Cardiology and Cardiovascular Medicine
business
Abdominal surgery
Aortic Aneurysm, Abdominal
Subjects
Details
- ISSN :
- 10976809
- Volume :
- 66
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of vascular surgery
- Accession number :
- edsair.doi.dedup.....84d66e495a075352d6ab7d6092705d55