A STUDY ON THE PATENCY OF THE INFERIOR MESENTERIC AND LUMBAR ARTERIESIN THE INCIDENCE OF ENDOLEAK FOLLOWING ENDOVASCULAR REPAIR OF INFRARENAL AORTIC-ANEURYSMS

Objective: An endoleak is defined as the presence of contrast medium w ithin the aneurysm sac on post-operative contrast-enhanced computed to mography scans (CT) in patients following endovascular repair (EVR) of abdominal aortic aneurysms (AAA), The aim of this study was to correl ate the incidence of endoleaks with the presence of patent lumbar (LA) and inferior mesenteric arteries (IMA) as seen on pre-operative angio graphy, Design, Materials and Methods: Forty-seven patients were asses sed pre-operatively by both CT and angiography by a blinded radiologis t prior to EVR of AAA, The number and size of patent vessels was recor ded and correlated with the incidence of LA or IMA endoleaks on follow -up CT. Patent lumbar vessels were scored: 1 = small, 2 = medium, 3 = large, Results: Five patients were noted to have patent IMA on pre-ope rative angiography but none developed an endoleak, In this series, fiv e patients had an endoleak due to a patent LA. The median score for pa tients with no endoleak was 1 (0-9) and for those with a lumbar endole ak 2 (0-5) (P = 0.26, Mann-Whitney U-test), The number of patent lumba r arteries was not predictive of a subsequent endoleak, Two out of nin e (22%) patients,vith large patent LA subsequently developed an endole ak, If a policy of pre-operative embolization on the basis of large pa tent LA had been adopted, seven patients would have had an unnecessary invasive procedure. Conclusion: Pre-operative angiography to look for patent LA and IMAs is not required in patients undergoing EVR or AAA.