Academic Journal
Prevention of Aneurysm Sac Enlargement after Endovascular Aneurysm Repair by Embolization of the Inferior Mesenteric and Lumbar Arteries.
| Τίτλος: | Prevention of Aneurysm Sac Enlargement after Endovascular Aneurysm Repair by Embolization of the Inferior Mesenteric and Lumbar Arteries. |
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| Συγγραφείς: | Seike Y; Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan. Electronic address: ys46421g@ncvc.go.jp., Yoshida K; Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan., Koda Y; Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan., Shijo T; Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan., Inoue Y; Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan., Horinouchi H; Department of Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan., Fukuda T; Department of Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan., Matsuda H; Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan. |
| Πηγή: | Annals of vascular surgery [Ann Vasc Surg] 2026 Sep; Vol. 130, pp. 361-371. Date of Electronic Publication: 2026 May 19. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 8703941 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1615-5947 (Electronic) Linking ISSN: 08905096 NLM ISO Abbreviation: Ann Vasc Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2007->: Netherlands : Elsevier Original Publication: Detroit : [Published by Expansion scientifique française for Annals of Vascular Surgery, Inc. and Association pour la promotion de la chirurgie vasculaire, Paris, c1986- |
| Ιατρικοί όροι (MeSH): | Endovascular Aneurysm Repair*/adverse effects , Embolization, Therapeutic*/adverse effects , Endoleak*/etiology , Endoleak*/prevention & control , Endoleak*/diagnostic imaging , Mesenteric Artery, Inferior*/diagnostic imaging , Aortic Aneurysm, Abdominal*/surgery , Aortic Aneurysm, Abdominal*/diagnostic imaging , Blood Vessel Prosthesis Implantation*/adverse effects , Lumbosacral Region*/blood supply, Humans ; Female ; Time Factors ; Male ; Retrospective Studies ; Aged ; Risk Factors ; Aged, 80 and over ; Treatment Outcome ; Progression-Free Survival |
| Περίληψη: | Background: This study assessed whether preemptive side branch embolization improves early to mid-term outcomes after endovascular aneurysm repair (EVAR), focusing on sac enlargement and reintervention for persistent type II endoleak. Methods: A total of 536 patients were included and categorized into three periods based on embolization strategy. In period 1 (n = 142), no preemptive embolization was performed. In period 2 (n = 111), inferior mesenteric artery (IMA) embolization was conducted when indicated. In period 3 (n = 283), embolization of the IMA and/or lumbar arteries (LAs) was performed according to anatomical findings. Early and mid-term outcomes were evaluated across all three periods, with additional analysis performed using propensity score matching (PSM). Results: Freedom from sac enlargement (≥5 mm) was comparable between period 1 and period 2 groups (log-rank, P = 0.45) but was significantly higher in period 3 than in period 2 (log-rank, P < 0.01) and was significantly higher in period 3 compared to period 1 (log-rank, P < 0.01). Freedom from reintervention, including aneurysm rupture prior to reintervention, did not differ significantly among the three groups. After PSM, the period 3 group demonstrated significantly greater freedom from sac enlargement (log-rank, P < 0.01), whereas the rates of reintervention or rupture remained statistically similar across the groups. Conclusion: An aggressive embolization strategy targeting both the IMA and LA was safe and associated with favorable early outcomes. Mid-term results suggested effective suppression of sac enlargement after EVAR. However, longer-term follow-up is required to confirm sustained benefits in reducing reintervention and rupture. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Entry Date(s): | Date Created: 20260520 Date Completed: 20260707 Latest Revision: 20260707 |
| Update Code: | 20260707 |
| DOI: | 10.1016/j.avsg.2026.05.069 |
| PMID: | 42162860 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1615-5947 |
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| DOI: | 10.1016/j.avsg.2026.05.069 |