Systematic review of laparoscopic ligation of inferior mesenteric artery for the treatment of type II endoleak after endovascular aortic aneurysm repair

Abstract

Laparoscopic ligation of the IMA for treatment of type II endoleak after EVAR is a feasible and safe technique in specialized centers with high technical success rate and good midterm outcomes.

Secondary Endoleak Management Following TEVAR and EVAR

“…Outcomes of transarterial embolisation: There is a relatively wide spread of reported technical and clinical success rates for this technique (Table 3 ), which is reflected in several meta-analysis and systemic reviews published recently [ 36 , 37 , 39 ]. One of the largest single cohorts published in 2012 of 95 patients undergoing 140 embolisation procedures (predominantly transarterial but a few other techniques too), using a range of embolics (glue 61%, coils 29%, glue and coils 7% and Gelfoam 3%) showed 81.5% freedom from aneurysm sac expansion at one year but a significant decrease to 43.7% at five years, with an associated increase in the number of repeat embolisation procedures required [ 40 ].…”

Natural History, Diagnosis, and Management of Type II Endoleaks after Endovascular Aortic Repair: Review and Update

“…108 Open conversion for T2ELs may be reasonably safe under elective circumstances, especially with endograft-preserving techniques. 109 Nevertheless, it arguably remains more invasive than any endovascular approach and typically less desirable given the significant medical comorbidities of patients selected for EVAR. 110…”

Recent Update of Endovascular Type 2 Endoleak Management

“…No systematic reviews have directly compared endovascular interventions with open/laparoscopic treatments, although several systematic reviews of surgical approaches have been reported [44,45]. In these reviews, high technical success rates of 90% and 30-day mortality rates of 1.5% or 0% were reported.…”