Impact of the Patency of Inferior Mesenteric Artery on 7-Year Outcomes After Endovascular Aneurysm Repair

Ide, Toru; Shimamura, Kazuo; Kuratani, Toru; Shijo, Takayuki; Sakaniwa, Ryoto; Watanabe, Yoshiki; Maeda, Koichi; Masada, Kenta; Yamashita, Kizuku; Matsumoto, Ryota; Miyagawa, Shigeru

doi:https://doi.org/10.1177/15266028221121748

Impact of the Patency of Inferior Mesenteric Artery on 7-Year Outcomes After Endovascular Aneurysm Repair

Ide, Toru; Shimamura, Kazuo; Kuratani, Toru et al.

Journal of Endovascular Therapy, 2022, none

Number of Access:1,655（2025-07-18 10:00 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/89662

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Title	Impact of the Patency of Inferior Mesenteric Artery on 7-Year Outcomes After Endovascular Aneurysm Repair
Creator	CreatorName Ide, Toru
	NRID 1000010507205 1000010507205 researchmap permalink kazuo-shimamura kazuo-shimamura Scopus Author ID 35969640700 35969640700 CreatorName Shimamura, Kazuo
	NRID 1000090448035 1000090448035 researchmap permalink Osaka1 Osaka1 Scopus Author ID 6701633706 6701633706 CreatorName Kuratani, Toru
	NRID 1000000644890 1000000644890 researchmap permalink t-shijo t-shijo Scopus Author ID 35793054800 35793054800 CreatorName Shijo, Takayuki
	NRID 1000020915649 1000020915649 researchmap permalink rytsknw rytsknw Scopus Author ID 57195982602 57195982602 CreatorName Sakaniwa, Ryoto
	NRID 1000050748746 1000050748746 CreatorName Watanabe, Yoshiki
	NRID 1000050644994 1000050644994 researchmap permalink koichi-maeda koichi-maeda Scopus Author ID 55318832600 55318832600 CreatorName Maeda, Koichi
	NRID 1000060770584 1000060770584 CreatorName Masada, Kenta
	NRID 1000060778661 1000060778661 researchmap permalink ky_osaka-u_2020 ky_osaka-u_2020 Scopus Author ID 57188740592 57188740592 CreatorName Yamashita, Kizuku
	CreatorName Matsumoto, Ryota
	NRID 1000070544237 1000070544237 ORCID 0000-0003-0015-6569 0000-0003-0015-6569 researchmap permalink s-miyagawa3154 s-miyagawa3154 Scopus Author ID 55560624700 55560624700 CreatorName Miyagawa, Shigeru
Subject	abdominal aortic aneurysm
	endoleak
	endovascular aneurysm repair
	inferior mesenteric artery
Description	Ide T, Shimamura K, Kuratani T, et al. Impact of the Patency of Inferior Mesenteric Artery on 7-Year Outcomes After Endovascular Aneurysm Repair. Journal of Endovascular Therapy. 2022. Copyright © 2022 The Author(s). doi:10.1177/15266028221121748.
Abstract	Purpose: The impact of preoperative patent inferior mesenteric artery (IMA) on late outcomes following endovascular aneurysm repair (EVAR) remains unclear. This study aimed to investigate the specific influence of IMA patency on 7-year outcomes after EVAR. Materials and Methods: In this retrospective cohort study, 556 EVARs performed for true abdominal aortic aneurysm cases between January 2006 and December 2019 at our institution were reviewed. Endovascular aneurysm repairs performed using a commercially available device with no type I or type III endoleak (EL) during follow-up and with follow-up ≥12 months were included. A total of 336 patients were enrolled in this study. The cohort was divided into the patent IMA group and the occluded IMA group according to preoperative IMA status. The late outcomes, including aneurysm sac enlargement, reintervention, and mortality rates, were compared between both groups using propensity-score-matched data. Results: After propensity score matching, 86 patients were included in each group. The median follow-up period was 56 months (interquartile range: 32–94 months). The incidence of type II EL at discharge was 50% in the patent IMA group and 19% in the occluded IMA group (p<0.001). The type II EL from IMA and lumbar arteries was significantly higher in the patent IMA group than in the occluded IMA group (p<0.001 and p=0.002). The rate of freedom from aneurysm sac enlargement with type II EL was significantly higher in the occluded IMA group than in the patent IMA group (94% vs 69% at 7 years; p<0.001). The rate of freedom from reintervention was significantly higher in the occluded IMA group than in the patent IMA group (90% vs 74% at 7 years; p=0.007). Abdominal aortic aneurysm–related death and all-cause mortality did not significantly differ between groups (p=0.32 and p=0.34). Conclusions: Inferior mesenteric artery patency could affect late reintervention and aneurysm sac enlargement but did not have a significant impact on mortality. Preoperative assessment and embolization of IMA might be an important factor for improvement in late EVAR outcomes. Clinical Impact: The preoperative patency of the inferior mesenteric artery was significantly associated with a higher incidence of sac enlargement and reintervention with type II endoleak following endovascular aneurysm repair, even after adjustment for patient background. Preoperative assessment and embolization of inferior mesenteric artery might be an important factor for improvement in late EVAR outcomes.
Publisher	SAGE Publications
Source Title	Journal of Endovascular Therapy
Page	none
Date of Issued	2022-09-17
Language	English
Handle URL	https://hdl.handle.net/11094/89662
PISSN	15266028
eISSN	15451550
NCID	AA11432895
Relation.isVersionOf	DOI (Publisher Version) https://doi.org/10.1177/15266028221121748
Access Rights	open access
oaire:version	Accepted Manuscript
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Journal of Endovascular Therapy. 2022, p. none
DC.title	Impact of the Patency of Inferior Mesenteric Artery on 7-Year Outcomes After Endovascular Aneurysm Repair
DC.creator	Ide, Toru
	Shimamura, Kazuo
	Kuratani, Toru
	Shijo, Takayuki
	Sakaniwa, Ryoto
	Watanabe, Yoshiki
	Maeda, Koichi
	Masada, Kenta
	Yamashita, Kizuku
	Matsumoto, Ryota
	Miyagawa, Shigeru
DC.publisher	SAGE Publications
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2022-09-17
DC.identifier	https://doi.org/10.1177/15266028221121748
DC.subject	abdominal aortic aneurysm
	endoleak
	endovascular aneurysm repair
	inferior mesenteric artery
DC.description	Ide T, Shimamura K, Kuratani T, et al. Impact of the Patency of Inferior Mesenteric Artery on 7-Year Outcomes After Endovascular Aneurysm Repair. Journal of Endovascular Therapy. 2022. Copyright © 2022 The Author(s). doi:10.1177/15266028221121748.
DCTERMS.abstract	Purpose: The impact of preoperative patent inferior mesenteric artery (IMA) on late outcomes following endovascular aneurysm repair (EVAR) remains unclear. This study aimed to investigate the specific influence of IMA patency on 7-year outcomes after EVAR. Materials and Methods: In this retrospective cohort study, 556 EVARs performed for true abdominal aortic aneurysm cases between January 2006 and December 2019 at our institution were reviewed. Endovascular aneurysm repairs performed using a commercially available device with no type I or type III endoleak (EL) during follow-up and with follow-up ≥12 months were included. A total of 336 patients were enrolled in this study. The cohort was divided into the patent IMA group and the occluded IMA group according to preoperative IMA status. The late outcomes, including aneurysm sac enlargement, reintervention, and mortality rates, were compared between both groups using propensity-score-matched data. Results: After propensity score matching, 86 patients were included in each group. The median follow-up period was 56 months (interquartile range: 32–94 months). The incidence of type II EL at discharge was 50% in the patent IMA group and 19% in the occluded IMA group (p<0.001). The type II EL from IMA and lumbar arteries was significantly higher in the patent IMA group than in the occluded IMA group (p<0.001 and p=0.002). The rate of freedom from aneurysm sac enlargement with type II EL was significantly higher in the occluded IMA group than in the patent IMA group (94% vs 69% at 7 years; p<0.001). The rate of freedom from reintervention was significantly higher in the occluded IMA group than in the patent IMA group (90% vs 74% at 7 years; p=0.007). Abdominal aortic aneurysm–related death and all-cause mortality did not significantly differ between groups (p=0.32 and p=0.34). Conclusions: Inferior mesenteric artery patency could affect late reintervention and aneurysm sac enlargement but did not have a significant impact on mortality. Preoperative assessment and embolization of IMA might be an important factor for improvement in late EVAR outcomes. Clinical Impact: The preoperative patency of the inferior mesenteric artery was significantly associated with a higher incidence of sac enlargement and reintervention with type II endoleak following endovascular aneurysm repair, even after adjustment for patient background. Preoperative assessment and embolization of inferior mesenteric artery might be an important factor for improvement in late EVAR outcomes.
DC.format	89662
citation_title	Impact of the Patency of Inferior Mesenteric Artery on 7-Year Outcomes After Endovascular Aneurysm Repair
citation_author	Ide, Toru
	Shimamura, Kazuo
	Kuratani, Toru
	Shijo, Takayuki
	Sakaniwa, Ryoto
	Watanabe, Yoshiki
	Maeda, Koichi
	Masada, Kenta
	Yamashita, Kizuku
	Matsumoto, Ryota
	Miyagawa, Shigeru
citation_publisher	SAGE Publications
citation_language	English
citation_date	2022-09-17
citation_journal_title	Journal of Endovascular Therapy
citation_firstpage	none
citation_doi	https://doi.org/10.1177/15266028221121748
citation_public_url	https://hdl.handle.net/11094/89662

Impact of the Patency of Inferior Mesenteric Artery on 7-Year Outcomes After Endovascular Aneurysm Repair

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