Applied Anatomy Study Of Involved Artery Of Type Ⅱ Endoleak After (EVAR)

Objective: To obsever the anatomic data of involved artery of typeⅡendoleak after (EVAR) ,in order to provide the clinical application of selective arteriography, the approach of catheteriation and methods of embolization for typeⅡendoleak. And explore the clinical sense.Methods:The outer diameter of the beginning end, position, tendency, distance to abdominal aorta furcation and relevant included angle of the following arteries of 30 adults corpses(18male,12female) were observed and analyzed statistically: the superior mesenteric artery(SMA)and inferior mesenteric artery(SMA),lumbar artery(LA), median sacral artery, internal iliac artery, iliolumbar artery and accessory renal artery possibly appearing.According to the results,The clinical signaficance was initially discussed.Results: Both the superior mesenteric artery(SMA)and Inferior mesenteric artery(SMA) begin from the anterior aortic wall with fixed location and less variation. Their included angels with abdominal aorta were 50°and 23°respectively.For all the sample adult corpses, the marginal arteries were complete without variation and absence,Arc of Riolan was not found. Accessory renal arteries were observed in 2 bodies (frequency: 6.7%) with big differences in the beginning and originating height. The number and course of lumbar artery and median sacral arterywere constant. There are 30 cases(30/30)of lumber artery symmetric distribution.among which27cases(27/30) of four pair,1 cases(1/30) of three pair and 2 cases(/30)of five pair of lumbar,which had the same tendency with the inferior part of its vertebral body and anastomosed with the iliolumbar artery. The included angel of the internal and external iliac artery was small(26°)or even 0°with almost parallel descent.Conclusion: Understood the anatomy characteristics of involved artery of typeⅡendoleak, which were the precondition of embolization treatment. In order to get better therapeutic efficacy, different catheteriation channels and methods are suggested to be chosen on the basis of the distribution and anastomosis variation of involved artery,a combination of transvascular and direct sac punctur embolization techniques has allowed to treat these endoleaks also.