{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:30:39Z","timestamp":1790775039023,"version":"4.1.0"},"reference-count":35,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2022,9,19]],"date-time":"2022-09-19T00:00:00Z","timestamp":1663545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Type II endoleak is one of the most common and problematic complications after endovascular aneurysm repair. It has been suggested that the inferior mesenteric artery (IMA) embolization could prevent further adverse events and postoperative complications. This article is a systematic review and meta-analysis following PRISMA guidelines. The Medline, PubMed, Embase, and Cochrane databases were used to identify studies that investigated the effect of IMA embolization on the occurrence of type II endoleaks and secondary interventions in a group of patients with abdominal aortic aneurysm who underwent EVAR compared with results after EVAR procedure without embolization. A random effects meta-analysis was performed. Of 3510 studies, 6 studies involving 659 patients were included. Meta-analysis of all studies showed that the rate of secondary interventions was smaller in patients with IMA embolization (OR, 0.17; SE, 0.45; 95% CI, 0.07 to 0.41; p &lt; 0.01; I2 = 0%). The occurrence of type II endoleaks was also smaller in the embolization group (OR, 0.37; SE, 0.21; 95% CI, 0.25 to 0.57; p &lt; 0.01; I2 = 16.20%). This meta-analysis suggests that IMA embolization correlates with lower rates of type II endoleaks and secondary interventions.<\/jats:p>","DOI":"10.3390\/jcm11185491","type":"journal-article","created":{"date-parts":[[2022,9,19]],"date-time":"2022-09-19T21:47:27Z","timestamp":1663624047000},"page":"5491","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Effectiveness of Inferior Mesenteric Artery Embolization on Type II Endoleak-Related Complications after Endovascular Aortic Repair (EVAR): Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6031-2757","authenticated-orcid":false,"given":"Natalia","family":"Niklas","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Pomeranian Medical University in Szczecin, Al. Powsta\u0144c\u00f3w Wielkopolskich 72, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michalina","family":"Malec","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Pomeranian Medical University in Szczecin, Al. Powsta\u0144c\u00f3w Wielkopolskich 72, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Gutowski","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Pomeranian Medical University in Szczecin, Al. Powsta\u0144c\u00f3w Wielkopolskich 72, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6670-927X","authenticated-orcid":false,"given":"Arkadiusz","family":"Kazimierczak","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Pomeranian Medical University in Szczecin, Al. Powsta\u0144c\u00f3w Wielkopolskich 72, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3365-1822","authenticated-orcid":false,"given":"Pawe\u0142","family":"Rynio","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Pomeranian Medical University in Szczecin, Al. Powsta\u0144c\u00f3w Wielkopolskich 72, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1001\/jamasurg.2015.2644","article-title":"Survival after endovascular vs open aortic aneurysm repairs","volume":"150","author":"Chang","year":"2015","journal-title":"JAMA Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"138","DOI":"10.21037\/cdt.2017.09.17","article-title":"Complications of endovascular aneurysm repair of the thoracic and abdominal aorta: Evaluation and management","volume":"8","author":"Daye","year":"2018","journal-title":"Cardiovasc. Diagn. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.avsg.2016.05.106","article-title":"Preoperative Inferior Mesenteric Artery Embolization: A Valid Method to Reduce the Rate of Type II Endoleak after EVAR?","volume":"39","author":"Manunga","year":"2017","journal-title":"Ann. Vasc. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.ejvs.2015.06.116","article-title":"Is Inferior Mesenteric Artery Embolization Indicated Prior to Endovascular Repair of Abdominal Aortic Aneurysm?","volume":"50","author":"Biancari","year":"2015","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1016\/j.jvir.2021.05.023","article-title":"Outcomes of Preventive Embolization of the Inferior Mesenteric Artery during Endovascular Abdominal Aortic Aneurysm Repair","volume":"32","author":"Petit","year":"2021","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"259","DOI":"10.3400\/avd.ra.18-00064","article-title":"Effectiveness of Embolization of Inferior Mesenteric Artery to Prevent Type II Endoleak Following Endovascular Aneurysm Repair: A Review of the Literature","volume":"11","author":"Samura","year":"2018","journal-title":"Ann. Vasc. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"947809","DOI":"10.3389\/fcvm.2022.947809","article-title":"Systematic review and network meta-analysis of pre-emptive embolization of the aneurysm sac side branches and aneurysm sac coil embolization to improve the outcomes of endovascular aneurysm repair","volume":"9","author":"Wu","year":"2022","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1177\/1526602819878411","article-title":"Sac Embolization and Side Branch Embolization for Preventing Type II Endoleaks After Endovascular Aneurysm Repair: A Meta-analysis","volume":"27","author":"Li","year":"2020","journal-title":"J. Endovasc. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1016\/j.jvs.2020.05.020","article-title":"Systematic review and meta-analysis of prophylactic aortic side branch embolization to prevent type II endoleaks","volume":"72","author":"Wanhainen","year":"2020","journal-title":"J. Vasc. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s13643-021-01626-4","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"10","author":"Page","year":"2021","journal-title":"Syst. Rev."},{"key":"ref_11","first-page":"49","article-title":"A 24-step guide on how to design, conduct, and successfully publish a systematic review and meta-analysis in medical research","volume":"351","author":"Muka","year":"2019","journal-title":"Eur. J. Epidemiol."},{"key":"ref_12","unstructured":"Kmet, L., Cook, L., and Lee, R. (2004). Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields, Alberta Heritage Foundation for Medical Research."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1177\/152660280701400509","article-title":"Strategies to Reduce the Rate of Type II Endoleaks: Routine Intraoperative Embolization of the Inferior Mesenteric Artery and Thrombin Injection Into the Aneurysm Sac","volume":"14","author":"Muthu","year":"2007","journal-title":"J. Endovasc. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1583\/12-4188MR.1","article-title":"Endovascular Abdominal Aneurysm Repair and Impact of Systematic Preoperative Embolization of Collateral Arteries: Endoleak Analysis and Long-term Follow-up","volume":"20","author":"Alerci","year":"2013","journal-title":"J. Endovasc. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/j.jvir.2016.12.1223","article-title":"Preoperative Coil Embolization of Side Branches and Postoperative Antifibrinolytic Therapy in Endovascular Aneurysm Repair: A Propensity Score Analysis","volume":"28","author":"Hiraoka","year":"2017","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1067\/mva.2002.125023","article-title":"Type II endoleaks: Predictable, preventable, and sometimes treatable?","volume":"36","author":"Parry","year":"2002","journal-title":"J. Vasc. Surg."},{"key":"ref_17","first-page":"E130","article-title":"Selective Inferior Mesenteric Artery Embolization during Endovascular Abdominal Aortic Aneurysm Repair to Prevent Type II Endoleak","volume":"63","author":"Fukuda","year":"2017","journal-title":"Kobe J. Med. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.jvs.2021.11.070","article-title":"Prophylactic sac out fl ow vessel embolization is associated with improved sac regression in patients undergoing endovascular aortic aneurysm repair","volume":"76","author":"Rokosh","year":"2021","journal-title":"J. Vasc. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.avsg.2021.06.037","article-title":"Midterm Outcomes of Endovascular Abdominal Aortic Aneurysm Repair with Prevention of type 2 Endoleak by Intraoperative Aortic Side Branch Coil","volume":"78","author":"Aoki","year":"2022","journal-title":"Ann. Vasc. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.1016\/j.jvs.2020.11.032","article-title":"Type II endoleak and aortic aneurysm sac shrinkage after preemptive embolization of aneurysm sac side branches","volume":"73","author":"Branzan","year":"2020","journal-title":"J. Vasc. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Nakayama, H., Toma, M., Kobayashi, T., and Sato, Y. (2022). Abdominal Aortic Aneurysm Shrinkage up to 2 Years Following Endovascular Repair with PEmbolization for Preventing Type 2 Endoleak: A Retrospective Single Center Study. Ann. Vasc. Surg., 1\u201310.","DOI":"10.1016\/j.avsg.2022.06.008"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1097\/SLA.0000000000003299","article-title":"Endovascular aneurysm repair with inferior mesenteric artery embolization for preventing type II Endoleak: A prospective randomized controlled trial","volume":"271","author":"Samura","year":"2020","journal-title":"Ann. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.jvir.2012.09.022","article-title":"Preoperative inferior mesenteric artery embolization before endovascular aneurysm repair: Decreased incidence of type II endoleak and aneurysm sac enlargement with 24-month follow-up","volume":"24","author":"Ward","year":"2013","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.jvir.2009.10.014","article-title":"Inferior Mesenteric Artery Embolization before Endovascular Repair of an Abdominal Aortic Aneurysm: Effect on Type II Endoleak and Aneurysm Shrinkage","volume":"21","author":"Nevala","year":"2010","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1097\/01.RVI.0000141342.42484.90","article-title":"Inferior mesenteric artery embolization before endovascular aneurysm repair: Technique and initial results","volume":"15","author":"Axelrod","year":"2004","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.avsg.2019.03.012","article-title":"Preoperative Inferior Mesenteric Artery Embolization is a Cost-effective Technique that May Reduce the Rate of Aneurysm Sac Diameter Enlargement and Reintervention After EVAR","volume":"60","author":"Vaillant","year":"2019","journal-title":"Ann. Vasc. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/S1051-0443(07)61913-7","article-title":"Aortic side branch embolization before endovascular aneurysm repair: Incidence of type II endoleak","volume":"12","author":"Gould","year":"2001","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2366","DOI":"10.1016\/S0140-6736(16)31135-7","article-title":"Endovascular versus open repair of abdominal aortic aneurysm in 15-years\u2019 follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): A randomised controlled trial","volume":"388","author":"Patel","year":"2016","journal-title":"Lancet"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta16090","article-title":"The UK EndoVascular Aneurysm Repair (EVAR) trials: Randomised trials of EVAR versus standard therapy","volume":"16","author":"Brown","year":"2012","journal-title":"Health Technol. Assess."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/S0140-6736(04)16979-1","article-title":"Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: Randomised controlled trial","volume":"364","author":"Greenhalgh","year":"2004","journal-title":"Lancet"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jvs.2007.02.073","article-title":"Persistent type 2 endoleak after endovascular repair of abdominal aortic aneurysm is associated with adverse late outcomes","volume":"46","author":"Jones","year":"2007","journal-title":"J. Vasc. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1007\/s00595-015-1115-5","article-title":"Analysis of anatomical risk factors for persistent type II endoleaks following endovascular abdominal aortic aneurysm repair using CT angiography","volume":"46","author":"Otsu","year":"2016","journal-title":"Surg. Today"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1016\/j.jvs.2003.12.033","article-title":"Predicting aneurysm enlargement in patients with persistent type II endoleaks","volume":"39","author":"Timaran","year":"2004","journal-title":"J. Vasc. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"S131","DOI":"10.21037\/cdt.2017.08.06","article-title":"Type II endoleaks: Diagnosis and treatment algorithm","volume":"8","author":"Bryce","year":"2018","journal-title":"Cardiovasc. Diagn. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1097\/MNH.0000000000000389","article-title":"Maximum Allowable Contrast Dose and Prevention of Acute Kidney Injury Following Cardiovascular Procedures","volume":"27","author":"Aoun","year":"2018","journal-title":"Curr. Opin. Nephrol. Hypertens."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/18\/5491\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:34:47Z","timestamp":1760142887000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/18\/5491"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,19]]},"references-count":35,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["jcm11185491"],"URL":"https:\/\/doi.org\/10.3390\/jcm11185491","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,19]]}}}