Inferior mesenteric artery embolization before endovascular repair of an abdominal aortic aneurysm: effect on type II endoleak and aneurysm shrinkage

Abstract

Purpose: To evaluate the value of preoperative embolization of the inferior mesenteric artery (IMA) before endovascular repair of an abdominal aortic aneurysm.

Materials and methods: From January 2000 to October 2006, 79 patients (mean age, 72.3 years; 69 men) scheduled for endovascular aneurysm repair (EVAR) were found to have a patent IMA at computed tomography. Coil embolization of the patent IMA was performed in 40 patients at Kuopio University Hospital, and their outcome was compared with that of 39 patients with a patent IMA who underwent EVAR at Oulu University Hospital without preoperative IMA embolization (control group). All patients were treated with a Zenith stent-graft. The mean follow-up time was 3.4 years +/- 1.7 (median, 3.1 years; range, 0-7.6 years).

Results: There were significantly fewer type II endoleaks in the IMA embolization group than in the control group (25% vs 59%, respectively; P = .002). Preoperative IMA embolization did not correlate with aneurysm size change. The overall linearized aneurysm shrinkage rate per year was 1.4 mm per year +/- 3.8 in the IMA embolization group and 1.7 mm per year +/- 2.4 in the control group (P = .72).

Conclusions: Preoperative coil embolization of the IMA reduced the frequency of type II endoleaks after EVAR, but the authors failed to show any influence on late postoperative aneurysm shrinkage.