Technical complications of endovascular abdominal aortic aneurysm repair

Abstract

Technical complications in this series seem to be associated with short distal necks, small iliac arteries, tortuous iliac arteries, and atherosclerosis at the aortic bifurcation. We believe that experience and understanding of these issues will reduce the risk of these complications in the future.

Methods for Three-Dimensional Geometric Characterization of the Arterial Vasculature

“…In the case of elective endovascular aneurysm repair (EVAR) alone, adverse anatomic features such as tortuosity at proximal neck and iliac fixation sites affect endograft placement and have been associated with the occurrence of endograft migration and endoleak 10,28,46 or iliac limb kinking resulting in graft thrombosis. 28,34,51,52 Difficulties in endograft sizing for complex and tortuous aneurysm morphologies often leads to the secondary placement of costly modular extensions in the common iliac arteries 56,60 or conversely inadvertent side branch occlusion, 28,29 factors which could adversely affect technical success of a procedure.…”

Requirement of intraoperative supportive procedures and complications in infrarenal abdominal aortic aneurysms due to iliac artery morphology

“…[15] Considering the current status of the technology for EVAR, problematic iliac anatomy is still a limiting issue for infrarenal AAAs. [16] The effect of iliac artery tortuosity or stenosis on complications upon EVAR was reported as 36%.…”

Access Sites to Vascular System for Endovascular Abdominal Aortic Aneurysms Repair

“…The rate of vascular access complications increases with narrow iliac artery diameter or large introducing system diameter 26 . Iliac artery diameters below 7 mm are associated with an increased incidence of complications 27 . Unfortunately, iliac artery rupture diagnosis is mostly imposssible before the introducing system withdrawal, and subsequent endovascular solution using stentgraft insertion is problematic 28 .…”