We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Laparoscopic Clipping of the Inferior Mesenteric Artery and Intraoperative Indocyanine Green Angiography for Type II Endoleak Following Endovascular Aneurysm Repair.
- Authors
Porta, Matteo; Cova, Marta; Segreti, Sara; Asti, Emanuele; Milito, Pamela; Trimarchi, Santi; Bonavina, Luigi
- Abstract
Background: Type II endoleaks from a patent inferior mesenteric artery (IMA) occur in up to one-third of patients undergoing endovascular repair of abdominal aortic aneurysms. In the majority of patients, retrograde flow in the aneurysmal sac outside the endograft will seal over time and is rarely associated with sac enlargement or aortic rupture. Intervention is generally recommended in patients with progressively enlarging endoleaks, especially when the sac diameter increases >10 mm during the follow-up, and endovascular IMA embolization has a high rate of treatment failure. Methods: We report a procedure of laparoscopic IMA clipping combined with intraoperative indocyanine green (ICG) angiography to confirm vascular anatomy, colonic perfusion, and the technical success of the procedure. Results: Three selected octogenarian patients with persistent type II endoleak after endovascular repair of abdominal aortic aneurysm underwent IMA clipping with ICG angiography. Mean operative time was 58 ± 9 minutes. There were no procedure-related complications, and no hypersensitivity reactions nor other side effects associated with ICG dye administration occurred. All patients were discharged home on postoperative day 1 and are asymptomatic and free of recurrence at a mean follow-up of 15 months. Conclusions: Laparoscopic IMA clipping is a safe remedial procedure in patients with type II endoleak after endovascular repair of abdominal aortic aneurysms.
- Subjects
INDOCYANINE green; MESENTERIC artery; ABDOMINAL aortic aneurysms; AORTIC aneurysms; ANEURYSMS; CEREBRAL angiography; BLOOD vessel prosthesis
- Publication
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2020, Vol 30, Issue 4, p413
- ISSN
1092-6429
- Publication type
journal article
- DOI
10.1089/lap.2019.0766