Surgical management of complications following endoluminal grafting of abdominal aortic aneurysms

Abstract

Endoluminal repair of AAA in our experience has a low perioperative (< 30 days) mortality rate (3.7%) but a high morbidity rate (75%). It is recommended that complications be classified into three groups: systemic/remote and local/vascular (following successful endoluminal repair) plus those complications leading to failure of endoluminal repair. The first group is composed of medical complications while the latter two groups comprise those surgical complications directly related to the endoluminal technique.

Geometric Changes in Aortic Endografts over a 2-Year Observation Period

“…[1][2][3][4][5][6] However, now that data from longer follow-up are becoming available, reports of secondary sequelae are appearing. [7][8][9] As one example, Harris et al 7 reported significant stent-graft kinking and buckling induced by longitudinal aneurysm shrinkage in almost 70% of their 26 cases after only 1 year.…”

Surgical corrections of endovascular aneurysms: Repair complications

“…The concept of having a "tool-box" con- . Surgical repair is thus indicated where endovascular repair is impossible or where it has failed 16 . Some reports present more frequently surgical procedures (as the technically easier option) used for complications solution early in their EVAR experience in contrast to later periods 9 .…”

“…Well accepted by patients and technically mostly successful endovascular procedures are the methods of choice for most solutions to EVAR complications [13][14][15] . Surgical procedures are indicated in cases when endovascular repair is impossible, if it has failed or its success probability is low 16 .…”

Improved Hybrid Technique for Vascular Access and Closure

“…Surgically-induced access complications can occur during circumferential preparation, arteriotomy, clamping, and wall closure. [1][2][3][4][5][6][7][8][9][10][11][12] Clamping and/or closure of the vessel can lead to plaque disruption, local dissection, stenosis, and even acute thrombosis. As a consequence, early or late complications, such as bleeding, aneurysm formation, occlusive disease, or acute limb ischemia, may occur.…”