title: Preoperative embolization of collateral side branches: a valid means to reduce type II endoleaks after endovascular AAA repair.
abstract: OBJECTIVE
  To report the results of preprocedural embolization of collateral branches arising from abdominal aortic aneurysms (AAA) scheduled for endovascular repair.
  
  
  METHODS
  Twenty-three consecutive AAA patients (all men; mean age 73 years, range 56-82) had coil embolization of patent lumbar and inferior mesenteric arteries (IMA) in a staged procedure prior to endovascular repair. Embolization with microcoils was attempted in 37 of the 52 identified lumbar arteries and 14 of 15 inferior mesenteric arteries. Follow-up included biplanar abdominal radiography, spiral computed tomography, and duplex ultrasonography at 1, 30, 90, and 180 days after the stent-graft procedure and at 6-month intervals thereafter.
  
  
  RESULTS
  Successful embolization was obtained in 24 (65%) of lumbar arteries, while all 14 (100%) IMAs were occluded with coils. No complication was associated with embolotherapy. Over a mean 17-month follow-up of 22 patients (1 intraoperative death), there was only 1 (4.5%) type II endoleak from a patent lumbar artery, with no sac expansion after 2 years. There were 4 (18%) type I and 1 (4.5%) type III endoleaks.
  
  
  CONCLUSIONS
  The embolization of side branches arising from an infrarenal aortic aneurysm before endovascular repair is feasible, with a high success rate; this maneuver may play a relevant role in reducing the rate of type II endoleak, improving long-term outcome.
authors.affiliation: Department of Vascular Medicine, Ospedale Regionale Bellinzona e Valli, Bellinzona, Switzerland.
authors.forename: Robert
authors.initials: R
authors.lastname: Bonvini
authors.forename: Mario
authors.initials: M
authors.lastname: Alerci
authors.forename: Francesco
authors.initials: F
authors.lastname: Antonucci
authors.forename: Paolo
authors.initials: P
authors.lastname: Tutta
authors.forename: Rolf
authors.initials: R
authors.lastname: Wyttenbach
authors.forename: Marcel
authors.initials: M
authors.lastname: Bogen
authors.forename: Angelo
authors.initials: A
authors.lastname: Pelloni
authors.forename: Ludwig
authors.initials: L
authors.lastname: Von Segesser
authors.forename: Augusto
authors.initials: A
authors.lastname: Gallino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D003097:Collateral Circulation; D004621:Embolization, Therapeutic / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008161:Lumbosacral Region / Q000098:blood supply / Q000601:surgery; D008297:Male; D008638:Mesenteric Arteries / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D015203:Reproducibility of Results; D016896:Treatment Outcome