Systematic review of laparoscopic ligation of inferior mesenteric artery for the treatment of type II endoleak after endovascular aortic aneurysm repair
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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. / Spanos, Konstantinos; Tsilimparis, Nikolaos; Larena-Avellaneda, Axel; Giannoukas, Athanasios D; Debus, Sebastian E; Kölbel, Tilo.
In: J VASC SURG, Vol. 66, No. 6, 12.2017, p. 1878-1884.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Systematic review of laparoscopic ligation of inferior mesenteric artery for the treatment of type II endoleak after endovascular aortic aneurysm repair
AU - Spanos, Konstantinos
AU - Tsilimparis, Nikolaos
AU - Larena-Avellaneda, Axel
AU - Giannoukas, Athanasios D
AU - Debus, Sebastian E
AU - Kölbel, Tilo
N1 - Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.
PY - 2017/12
Y1 - 2017/12
N2 - 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.
AB - 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.
KW - Aged
KW - Aged, 80 and over
KW - Aortic Aneurysm, Abdominal/diagnosis
KW - Blood Vessel Prosthesis Implantation/adverse effects
KW - Endoleak/diagnosis
KW - Endovascular Procedures/adverse effects
KW - Female
KW - Humans
KW - Laparoscopy/adverse effects
KW - Ligation
KW - Male
KW - Mesenteric Artery, Inferior/diagnostic imaging
KW - Middle Aged
KW - Splanchnic Circulation
KW - Treatment Outcome
U2 - 10.1016/j.jvs.2017.07.066
DO - 10.1016/j.jvs.2017.07.066
M3 - SCORING: Review article
C2 - 28822664
VL - 66
SP - 1878
EP - 1884
JO - J VASC SURG
JF - J VASC SURG
SN - 0741-5214
IS - 6
ER -
