Endovascular abdominal aneurysm repair and impact of systematic preoperative embolization of collateral arteries: Endoleak analysis and long-term follow-up

Mario Alerci, Alessia Giamboni, Rolf Wyttenbach, Alessandra Pia Porretta, Francesco Antonucci, Marcel Bogen, Marco Toderi, Adriano Guerra, Fabio Sartori, Paolo Tutta, Luigi Inglese, Costanzo Limoni, Augusto Gallino, Ludwig K. Von Segesser

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To report our results of endovascular aneurysm repair (EVAR) over a 10-year period using systematic preoperative collateral artery embolization. Methods: From 1999 until 2009, 124 patients (117 men; mean age 70.8 years) with abdominal aortic aneurysm (AAA) underwent embolization of patent lumbar and/or inferior mesenteric arteries prior to elective EVAR procedures. Embolization was systematically attempted and, whenever possible, performed using microcoils and a coaxial technique. Follow-up included computed tomography and/or magnetic resonance imaging and abdominal radiography. Results: The technical success for EVAR was 96% (119/124), with 4 patients dying within 30 days (3.2% perioperative mortality) and 1 type III endoleak accounting for the failures. Collateral arteries were occluded spontaneously or by embolization in 60 (48%) of 124 patients. The endoleak rate was 50.9% (74 in 61 patients), most of which were type II (19%). Over a mean clinical follow-up of 60.5±34.1 months (range 1-144), aneurysm sac dimensions decreased in 66 patients, increased in 19 patients, and were stable in 35. The endoleak rate was significantly higher in the patients with increasing sac diameter (p

Original languageEnglish
Pages (from-to)663-671
Number of pages9
JournalJournal of Endovascular Therapy
Volume20
Issue number5
DOIs
Publication statusPublished - Oct 2013

Keywords

  • Abdominal aortic aneurysm
  • Aneurysm rupture
  • Coil embolization
  • Endoleak
  • Endovascular aneurysm repair
  • Inferior mesenteric artery
  • Lumbar artery
  • Mortality
  • Outcome analysis
  • Preoperative side branch embolization
  • Sac diameter
  • Stent-graft

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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