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Prophylactic embolization of the inferior mesenteric artery (IMA) during endovascular aneurysm repair (EVAR) is recommended to prevent type 2 endoleak (T2EL). However, the impact of patent lumbar arteries (LAs) on T2ELs and aneurysm diameter has not been elucidated.

Background We aimed to investigate the incidence and risk factors of postoperative acute pancreatitis (PAP) following thoracic aortic surgery with circulatory arrest.Methods One hundred fifty-two patients who underwent thoracic aortic surgery with circulatory arrest between February 2015 and March 2023 were retrospectively reviewed. Postoperative acute pancreatitis was defined as the presence of two or more of the following criteria: (1) abdominal pain, (2) postoperative amylase or lipase levels greater than three times the upper limit of normal, and (3) evidence of pancreatitis on postoperative computed tomography (CT) scan. Univariate and multivariate analyses were performed to find risk factors for PAP.Results Nine patients (5.9%) developed PAP without mortality. All of the nine patients had elevated pancreatic enzymes and evidence of pancreatitis on CT. They improved with conservative therapy. In multivariate analysis, only cross-clamp time was found to be a significant risk factor for PAP (adjusted odds ratio, 1.04; 95% confidence interval, 1–1.08; p= 0.042).Conclusion The incidence of PAP after thoracic aortic surgery with circulatory arrest was 5.9%, and cross-clamp time is an independent risk factor for PAP.

Worldwide, there is a growing number of patients with myocardial ischemia and limb ischemia associated with the aging population and an increased prevalence of atherosclerotic diseases. Medical therapy, percutaneous angioplasty and surgical revascularization are the present treatments of choice, but such treatments are not feasible for some patients with severe atherosclerosis. Therapeutic angiogenesis using growth factors or progenitor cells has drawn great attention as a favorable alternative treatment for such patients. This review discusses clinical trials using angiogenic growth factors for myocardial ischemia and limb ischemia, and also introduces a novel controlled release system for growth factors using a gelatin hydrogel.