A case-control study of intentional occlusion of accessory renal arteries during endovascular aortic aneurysm repair

Malgor, Rafael D.; Oderich, Gustavo S.; Vrtiska, Terri J.; Kalra, Manju; Duncan, Audra A.; Gloviczki, Péter; Cha, Stephen; Bower, Thomas C.

doi:10.1016/j.jvs.2013.06.068

Cited by 45 publications

(63 citation statements)

References 23 publications

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“…Previous studies documented that the coverage of ARAs by endografts can be well tolerated in the short-and medium-term without significant impairment of renal function or deterioration of hypertension. [5][6][7][8][9][10][11] In contrast, Greenberg et al 10 reported that postoperative renal infarction was detected in 84% of patients after EVAR with ARA coverage, and that the mean volume of the infarcted area was 12% of the total renal volume, indicating a certain degree of ischemic damage to the kidney parenchyma. Malgor et al 11 reported that coverage of ARAs larger than 3 mm in diameter during EVAR could result in type II endoleak leading to aneurysm enlargement.…”

Section: Discussionmentioning

confidence: 98%

Preservation of the accessory renal arteries after endovascular repair of common iliac artery aneurysm using kissing stent grafts

Hosaka

Miyata

Nishiyama

et al. 2016

Journal of Vascular Surgery

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Exclusion of the accessory renal arteries (ARAs) is required during endovascular aneurysm repair if they arise from the sealing zone or aneurysm sac. Here, we report a case of successful endovascular treatment for a common iliac artery aneurysm located close to the aortic bifurcation and associated with nephrotic syndrome in a 51-year-old man. The bilateral ARAs were successfully preserved using kissing stent grafts. During surgery, the proximal ends of endografts inserted from the bilateral femoral arteries were adjusted so that they met at the same level in the aorta, and simultaneous balloon dilatation was performed. This method can be a useful treatment option for common iliac aneurysms in cases with large ARAs.

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Section: Discussionmentioning

confidence: 98%

Preservation of the accessory renal arteries after endovascular repair of common iliac artery aneurysm using kissing stent grafts

Hosaka

Miyata

Nishiyama

et al. 2016

Journal of Vascular Surgery

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“…However, more recent studies report a mild decline in postoperative renal function of patients with covered accessory renal artery after EVAR (26). In addition, coverage of larger (>3 mm) accessory renal artery has been associated with an increased risk of type II endoleak (27).…”

Section: Renal Arterymentioning

confidence: 99%

Repair of abdominal aortic aneurysms: preoperative imaging and evaluation

Pisimisis

Sheth

2018

Cardiovasc. Diagn. Ther.

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Imaging is a critical component of the pre-procedure evaluation and planning of endovascular aneurysm repair (EVAR). Imaging is the mainstay for proper assessment of procedural candidacy, relevant vascular anatomy, device selection, and surgical approach. Computed tomography angiography (CTA) has long been considered the preferred modality for pre-operative imaging and evaluation prior to EVAR.Recently, advances in image quality and software technology have further enhanced the proceduralist's ability to plan and perform EVAR. In this review, we highlight the current state of the art to provide interventionalists a contemporary assessment of the available tools for pre-operative imaging and evaluation prior to EVAR.

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“…However, in unique instances, intraoperative variables may also influence whether a Type II endoleak occurs in the postoperative period. Ward et al demonstrated that prophylactic embolization of a patent inferior mesenteric artery and/or lumbar arteries decreases the risk of a large persistent Type II endoleak [20]. On the other hand, in repairs that involve distal endograft fixation in the external iliac artery, an inadequate embolization and/or plugging of an internal iliac artery can lead to a persistent retrograde Type II endoleak from the branch vessel and into the aortic sac-particularly if the ipsilateral common and internal iliac arteries are also aneurysmal.…”

Section: Intraoperative Predictors Of Type II Endoleak Developmentmentioning

confidence: 99%

“…Treatment of Type II endoleaks by way of prevention is cited in various reports [19,20,25]. This is theoretically achieved with prophylactic embolization of arterial branches and collaterals that may ultimately lead to a Type II endoleak following EVAR.…”

Section: Treatment Of Type II Endoleaksmentioning

confidence: 99%

“…It is also less commonly proposed that prophylactic embolization can be performed of collateral arteries such as lumbar arteries, accessory renal arteries, or the inferior mesenteric artery [20,23,25,26]. However, it is commonly accepted that the benefit of these prophylactic adjunct interventions does not outweigh the associated procedural risk, cost, and time.…”

Section: Treatment Of Type II Endoleaksmentioning

confidence: 99%

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Abdominal Aortic Aneurysm Type II Endoleaks

Kuziez

Sánchez

Zayed

2016

J Cardiovasc Dis Diagn

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Type II endoleaks occur commonly following endovascular aneurysm repair (EVAR). Although they remain enigmatic, multiples studies have evaluated preoperative risk factors and strategies for prevention of type II endoleaks. Prophylactic treatment of type II endoleaks can include embolization of accessory arteries, as well as complete aneurysmal sac occlusion. Regular post-operative surveillance and screening for type II endoleaks with triple-phase CTA is the standard of care. Aneurysm size and growth rate are factors that predict whether a persistence type II endoleak is hemodynamically significant, and whether it requires treatment with percutaneous trans-lumbar or trans-arterial embolization techniques. Less commonly, type II endoleaks can be repaired using laparoscopic or open surgical ligation of feeder arterial branches. Emerging methods using endovascular aneurysm sac sealing technology may continue to alter the incidence and long-term management strategies of type II endoleaks. Here we review the latest strategies in the treatment of Type II endoleaks following EVAR.

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A case-control study of intentional occlusion of accessory renal arteries during endovascular aortic aneurysm repair

Cited by 45 publications

References 23 publications

Preservation of the accessory renal arteries after endovascular repair of common iliac artery aneurysm using kissing stent grafts

Preservation of the accessory renal arteries after endovascular repair of common iliac artery aneurysm using kissing stent grafts

Repair of abdominal aortic aneurysms: preoperative imaging and evaluation

Abdominal Aortic Aneurysm Type II Endoleaks

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