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Frequency and Significance of Lumbar and Inferior Mesenteric Artery Perfusion after Endovascular Repair of Abdominal Aortic Aneurysms
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...
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| Published in: | Journal of endovascular therapy 2004-12, Vol.11 (6), p.649-658 |
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| container_issue | 6 |
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| container_title | Journal of endovascular therapy |
| container_volume | 11 |
| creator | Fritz, Gerald A. Deutschmann, Hannes A. Schoellnast, Helmut Stessel, Uwe Sorantin, Erich Portugaller, Horst R. Quehenberger, Franz Hausegger, Klaus A. |
| description | 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 |
| doi_str_mv | 10.1583/04-1248MR.1 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67190047</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1583_04-1248MR.1</sage_id><sourcerecordid>67190047</sourcerecordid><originalsourceid>FETCH-LOGICAL-c347t-143a5d2b3a1295074865266944c69df99a2f80a1ac218e1239fc28345e01c31f3</originalsourceid><addsrcrecordid>eNptkU1rGzEQhkVpaD7aU-9F9BACZVONPta7R2OcNmCTkLRnIWtHQWFXciVvwD8g_ztybAiUnGYYPfOOZl5CvgK7BNWIn0xWwGWzvLuED-QElFQVKMU-7nJeVzXjzTE5zfmRMQ4c4BM5BlUXRNUn5Pkq4b8Rg91SEzp67x-Cd96aYJFGRxfjsDLp9ek6OEw-JrrEjGFTckunqcQtvcXkxuxjoMaVAp2HLj6ZbMe-9N7h2vi0E5uuujj4YHo6jWmzaw84pm0e8mdy5Eyf8cshnpG_V_M_s9_V4ubX9Wy6qKyQk00FUhjV8ZUwwFvFJrKpy4Z1K6Wt2861reGuYQaM5dAgcNE6yxshFTKwApw4I-d73XWKZeu80YPPFvveBIxj1vUEWsbkpIDf_wMf45jK17MuFwSQshEF-rGHbIo5J3R6nfxg0lYD0ztrNJN6b42GQn87SI6rAbs39uBFAS72QDYP-DbvPa0XidSVig</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211114483</pqid></control><display><type>article</type><title>Frequency and Significance of Lumbar and Inferior Mesenteric Artery Perfusion after Endovascular Repair of Abdominal Aortic Aneurysms</title><source>Sage Journals Online</source><creator>Fritz, Gerald A. ; Deutschmann, Hannes A. ; Schoellnast, Helmut ; Stessel, Uwe ; Sorantin, Erich ; Portugaller, Horst R. ; Quehenberger, Franz ; Hausegger, Klaus A.</creator><creatorcontrib>Fritz, Gerald A. ; Deutschmann, Hannes A. ; Schoellnast, Helmut ; Stessel, Uwe ; Sorantin, Erich ; Portugaller, Horst R. ; Quehenberger, Franz ; Hausegger, Klaus A.</creatorcontrib><description>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<0.05); there was no significant difference between groups 2a and 2b (p=0.88) relative to the number of pre-existing patent collaterals. The number of pLAs preoperatively and the rate of type II endoleak were significantly correlated (p<0.05). No type II endoleak was seen in patients without perfused side branches (p=0.01). No significant differences in mean volumes were found between groups 1 and 2a (no EL-II), but significant differences between groups 1 and 2b were seen in later follow-up.
Conclusions:
A larger number of patent LAs before EVR was associated with a significantly higher rate of type II endoleak. Patent collateral vessels were common after aneurysm repair, but the frequency decreased during follow-up. Persistent side branch perfusion was associated with increased type II endoleak after endovascular AAA repair. Significant differences in volume changes in later follow-up were seen between patients with or without type II endoleak.</description><identifier>ISSN: 1526-6028</identifier><identifier>EISSN: 1545-1550</identifier><identifier>DOI: 10.1583/04-1248MR.1</identifier><identifier>PMID: 15615556</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>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</subject><ispartof>Journal of endovascular therapy, 2004-12, Vol.11 (6), p.649-658</ispartof><rights>2004 SAGE Publications</rights><rights>Copyright Allen Press, Inc. Dec 2004</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-143a5d2b3a1295074865266944c69df99a2f80a1ac218e1239fc28345e01c31f3</citedby><cites>FETCH-LOGICAL-c347t-143a5d2b3a1295074865266944c69df99a2f80a1ac218e1239fc28345e01c31f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,79364</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15615556$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fritz, Gerald A.</creatorcontrib><creatorcontrib>Deutschmann, Hannes A.</creatorcontrib><creatorcontrib>Schoellnast, Helmut</creatorcontrib><creatorcontrib>Stessel, Uwe</creatorcontrib><creatorcontrib>Sorantin, Erich</creatorcontrib><creatorcontrib>Portugaller, Horst R.</creatorcontrib><creatorcontrib>Quehenberger, Franz</creatorcontrib><creatorcontrib>Hausegger, Klaus A.</creatorcontrib><title>Frequency and Significance of Lumbar and Inferior Mesenteric Artery Perfusion after Endovascular Repair of Abdominal Aortic Aneurysms</title><title>Journal of endovascular therapy</title><addtitle>J Endovasc Ther</addtitle><description>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<0.05); there was no significant difference between groups 2a and 2b (p=0.88) relative to the number of pre-existing patent collaterals. The number of pLAs preoperatively and the rate of type II endoleak were significantly correlated (p<0.05). No type II endoleak was seen in patients without perfused side branches (p=0.01). No significant differences in mean volumes were found between groups 1 and 2a (no EL-II), but significant differences between groups 1 and 2b were seen in later follow-up.
Conclusions:
A larger number of patent LAs before EVR was associated with a significantly higher rate of type II endoleak. Patent collateral vessels were common after aneurysm repair, but the frequency decreased during follow-up. Persistent side branch perfusion was associated with increased type II endoleak after endovascular AAA repair. Significant differences in volume changes in later follow-up were seen between patients with or without type II endoleak.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angiography</subject><subject>Aortic Aneurysm, Abdominal - diagnostic imaging</subject><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Blood Vessel Prosthesis</subject><subject>Blood Vessel Prosthesis Implantation - adverse effects</subject><subject>Blood Vessel Prosthesis Implantation - methods</subject><subject>Cohort Studies</subject><subject>Combined Modality Therapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Mesenteric Artery, Inferior</subject><subject>Middle Aged</subject><subject>Perfusion - methods</subject><subject>Postoperative Care - methods</subject><subject>Postoperative Complications - diagnostic imaging</subject><subject>Postoperative Complications - therapy</subject><subject>Probability</subject><subject>Prosthesis Failure</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Statistics, Nonparametric</subject><subject>Stents</subject><subject>Treatment Outcome</subject><issn>1526-6028</issn><issn>1545-1550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><recordid>eNptkU1rGzEQhkVpaD7aU-9F9BACZVONPta7R2OcNmCTkLRnIWtHQWFXciVvwD8g_ztybAiUnGYYPfOOZl5CvgK7BNWIn0xWwGWzvLuED-QElFQVKMU-7nJeVzXjzTE5zfmRMQ4c4BM5BlUXRNUn5Pkq4b8Rg91SEzp67x-Cd96aYJFGRxfjsDLp9ek6OEw-JrrEjGFTckunqcQtvcXkxuxjoMaVAp2HLj6ZbMe-9N7h2vi0E5uuujj4YHo6jWmzaw84pm0e8mdy5Eyf8cshnpG_V_M_s9_V4ubX9Wy6qKyQk00FUhjV8ZUwwFvFJrKpy4Z1K6Wt2861reGuYQaM5dAgcNE6yxshFTKwApw4I-d73XWKZeu80YPPFvveBIxj1vUEWsbkpIDf_wMf45jK17MuFwSQshEF-rGHbIo5J3R6nfxg0lYD0ztrNJN6b42GQn87SI6rAbs39uBFAS72QDYP-DbvPa0XidSVig</recordid><startdate>200412</startdate><enddate>200412</enddate><creator>Fritz, Gerald A.</creator><creator>Deutschmann, Hannes A.</creator><creator>Schoellnast, Helmut</creator><creator>Stessel, Uwe</creator><creator>Sorantin, Erich</creator><creator>Portugaller, Horst R.</creator><creator>Quehenberger, Franz</creator><creator>Hausegger, Klaus A.</creator><general>SAGE Publications</general><general>Allen Press Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>200412</creationdate><title>Frequency and Significance of Lumbar and Inferior Mesenteric Artery Perfusion after Endovascular Repair of Abdominal Aortic Aneurysms</title><author>Fritz, Gerald A. ; Deutschmann, Hannes A. ; Schoellnast, Helmut ; Stessel, Uwe ; Sorantin, Erich ; Portugaller, Horst R. ; Quehenberger, Franz ; Hausegger, Klaus A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-143a5d2b3a1295074865266944c69df99a2f80a1ac218e1239fc28345e01c31f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angiography</topic><topic>Aortic Aneurysm, Abdominal - diagnostic imaging</topic><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Blood Vessel Prosthesis</topic><topic>Blood Vessel Prosthesis Implantation - adverse effects</topic><topic>Blood Vessel Prosthesis Implantation - methods</topic><topic>Cohort Studies</topic><topic>Combined Modality Therapy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Mesenteric Artery, Inferior</topic><topic>Middle Aged</topic><topic>Perfusion - methods</topic><topic>Postoperative Care - methods</topic><topic>Postoperative Complications - diagnostic imaging</topic><topic>Postoperative Complications - therapy</topic><topic>Probability</topic><topic>Prosthesis Failure</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Statistics, Nonparametric</topic><topic>Stents</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fritz, Gerald A.</creatorcontrib><creatorcontrib>Deutschmann, Hannes A.</creatorcontrib><creatorcontrib>Schoellnast, Helmut</creatorcontrib><creatorcontrib>Stessel, Uwe</creatorcontrib><creatorcontrib>Sorantin, Erich</creatorcontrib><creatorcontrib>Portugaller, Horst R.</creatorcontrib><creatorcontrib>Quehenberger, Franz</creatorcontrib><creatorcontrib>Hausegger, Klaus A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endovascular therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fritz, Gerald A.</au><au>Deutschmann, Hannes A.</au><au>Schoellnast, Helmut</au><au>Stessel, Uwe</au><au>Sorantin, Erich</au><au>Portugaller, Horst R.</au><au>Quehenberger, Franz</au><au>Hausegger, Klaus A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Frequency and Significance of Lumbar and Inferior Mesenteric Artery Perfusion after Endovascular Repair of Abdominal Aortic Aneurysms</atitle><jtitle>Journal of endovascular therapy</jtitle><addtitle>J Endovasc Ther</addtitle><date>2004-12</date><risdate>2004</risdate><volume>11</volume><issue>6</issue><spage>649</spage><epage>658</epage><pages>649-658</pages><issn>1526-6028</issn><eissn>1545-1550</eissn><abstract>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<0.05); there was no significant difference between groups 2a and 2b (p=0.88) relative to the number of pre-existing patent collaterals. The number of pLAs preoperatively and the rate of type II endoleak were significantly correlated (p<0.05). No type II endoleak was seen in patients without perfused side branches (p=0.01). No significant differences in mean volumes were found between groups 1 and 2a (no EL-II), but significant differences between groups 1 and 2b were seen in later follow-up.
Conclusions:
A larger number of patent LAs before EVR was associated with a significantly higher rate of type II endoleak. Patent collateral vessels were common after aneurysm repair, but the frequency decreased during follow-up. Persistent side branch perfusion was associated with increased type II endoleak after endovascular AAA repair. Significant differences in volume changes in later follow-up were seen between patients with or without type II endoleak.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>15615556</pmid><doi>10.1583/04-1248MR.1</doi><tpages>10</tpages></addata></record> |
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| ispartof | Journal of endovascular therapy, 2004-12, Vol.11 (6), p.649-658 |
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| 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 |
| title | Frequency and Significance of Lumbar and Inferior Mesenteric Artery Perfusion after Endovascular Repair of Abdominal Aortic Aneurysms |
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