title: CT Findings of Risk Factors for Persistent Type II Endoleak from Inferior Mesenteric Artery to Determine Indicators of Preoperative IMA Embolization.
abstract: OBJECTIVE
  To identify the computed tomography (CT) findings of persistent type II endoleak from the inferior mesenteric artery (IMA) which indicate the need for preoperative IMA embolization.
  
  
  METHODS
  Included were 120 patients (96 males, 49-93 years old, mean: 77.7) who underwent endovascular aortic aneurysm repair (EVAR) between June 2007 and October 2010. The relationship between persistent type II endoleak and CT findings of IMA orifice was examined.
  
  
  RESULTS
  CT showed no type II endoleak from IMA in 106 patients (89%; Group N), and transient type II endoleak from IMA in 10 patients (8.3%; Group T). CT showed persistent type II endoleak from IMA in 4 patients (3.3%; Group P) and three of them underwent reintervention. Univariate Cox-Mantel test analysis indicated that stenosis (p = 0.0003) and thrombus (p = 0.043) in IMA orifice were significant factors for persistent type II endoleak. The ratios of patients with proximal IMA more than 2.5 mm diameter in Groups N, Y, and P were 26/106 (24%), 5/10 (50%) and 4/4 (100%), respectively.
  
  
  CONCLUSIONS
  Indicators for embolization of IMA prior to EVAR for the prevention of type II endoleak appear to be: (1) more than 2.5 mm in diameter and (2) no stenosis due to calcification or mural thrombus in IMA orifice.
authors.affiliation: Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Matsuda
authors.affiliation: Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sanda
authors.affiliation: Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Morita
authors.affiliation: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Minatoya
authors.affiliation: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Junjiro
authors.initials: J
authors.lastname: Kobayashi
authors.affiliation: Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Naito
keywords: CT; endovascular aneurysm repair; inferior mesenteric artery; type II endoleak