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May 9, 2026

Total Laparoscopic Inferior Mesenteric Artery Clipping for Persistent Type II Endoleak Following EVAR: A Case Report and Review of Surgical Strategy

MHMahmoud Badawi HassanCambridge University Hospitals NHS Foundation Trust TBT F BrowneMid Essex Hospital Services NHS Trust IPIoannis PrionidisMid Essex Hospital Services NHS Trust

Key Points

This report aims to evaluate the effectiveness of total laparoscopic inferior mesenteric artery clipping for treating persistent type II endoleak following EVAR.
Total laparoscopic inferior mesenteric artery clipping performed
Intraoperative ultrasound used for verification of endoleak cessation
Postoperative duplex imaging assessed endoleak volume
Immediate cessation of endoleak confirmed by intraoperative ultrasound
Postoperative duplex imaging showed reduced endoleak volume
Long-term follow-up imaging was not available

Abstract

. Subsequently, a total laparoscopic IMA clipping was performed with intraoperative ultrasound verification of immediate endoleak cessation. Early postoperative duplex demonstrated reduction in endoleak volume.ConclusionTotal laparoscopic IMA clipping is a feasible minimally invasive option for refractory type II endoleak. Intra-operative ultrasound can provide real-time physiological confirmation of flow cessation. Long-term cross-sectional follow-up imaging was unavailable.

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