Frequency and Significance of Lumbar and Inferior Mesenteric Artery Perfusion after Endovascular Repair of Abdominal Aortic Aneurysms

• Published in: Journal of endovascular therapy 2004-12, Vol.11 (6), p.649-658
• Main Authors: Fritz, Gerald A., Deutschmann, Hannes A., Schoellnast, Helmut, Stessel, Uwe, Sorantin, Erich, Portugaller, Horst R., Quehenberger, Franz, Hausegger, Klaus A.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Angiography; Aortic Aneurysm, Abdominal - diagnostic imaging; Aortic Aneurysm, Abdominal - surgery; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - methods; Cohort Studies; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Male; Mesenteric Artery, Inferior; Middle Aged; Perfusion - methods; Postoperative Care - methods; Postoperative Complications - diagnostic imaging; Postoperative Complications - therapy; Probability; Prosthesis Failure; Retrospective Studies; Risk Assessment; Severity of Illness Index; Statistics, Nonparametric; Stents; Treatment Outcome
• ISSN: 1526-6028; 1545-1550
• DOI: 10.1583/04-1248MR.1

Purpose: To evaluate the frequency and influence of perfused side branches (lumbar arteries [LA] and inferior mesenteric artery trunks) on development of type II endoleaks (EL-II) and on volume changes of abdominal aortic aneurysms (AAA) after endovascular repair. Methods: Of 114 patients undergoing EVR of AAA, 89 patients (83 men; mean age 72±7.5 years, range 51–88) with >6 months' follow-up and no type I endoleaks were retrospectively analyzed to determine any relationships between retrograde perfusion, endoleaks, and sac volume. Data were derived from computed tomographic angiographic (CTA) scans taken before and after intervention, at discharge, and at 1, 3, 6, and semi-annually thereafter in follow-up. Two groups were identified and compared based on their status at 6 months post EVR: without perfused side branches (group 1) and with perfused collaterals (group 2); group 2 was further divided according to the absence (2a) or presence (2b) of endoleak. Results: Median follow-up was 24 months (range 6–36). Based on a total of 582 CTAs analyzed, 17 (19%) patients developed type II endoleaks (EL-II) during follow-up. There was a significant difference in the number of perfused LAs prior to EVR between groups 1 (n=44) and the 45 patients with postprocedural patent collateral arteries in group 2 (p