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Vol 6, No 3 (2004)
Published online: 2004-10-04

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Perioperative complications after endovascular treatment of abdominal aortic aneurysms

Piotr Szopiński, Jarosław Iwanowski, Eliza Pleban, Witold Woźniak, Wojciech Noszczyk
Chirurgia Polska 2004;6(3):139-146.

Abstract

Background: The aim of the study was the evaluation of perioperative complications and a review of early interventions in patients undergoing endovascular abdominal aortic repair.
Material and methods: 26 abdominal aortic aneurysms (AAA) repaired endoluminally between 2002–2004 were analyzed. Two of them had been ruptured on admission. All patients were unfit for open surgery due to co-morbid factors. Eighteen Zenith (one fenestrated), 4 Endologix, 2 Medtronic, 1 Excluder, 1 Fortron endografts were used.
Results: There were no perioperative deaths and no conversions with the necessity of stent-graft removal. Nine complications were noticed: 3 endoleaks (two type II and one type I), 1 iliac artery injury, 1 uniiliac stent-graft thrombosis, 1 balloon catheter trapping inside the stent-graft during the dilation of a leg of the prosthesis and 3 groin haematomas.
The patient with type I endoleak as well as the patient with iliac artery damage were treated percutaneoously while the patients with graft occlusion and a balloon catheter hooked on the stent-graft struts were treated surgically. The groin haematomas were evacuated and in all cases femoral arteries were supplied with extra sutures.
Conclusions: The new generation of endovascular technology reduces the risk of death from AAA but do not entirely eliminate the possibility of complication occurrence. High risk patients present an increased risk of complications but if they occur, close co-operation between a vascular surgeon and a radiologist and the experience of the team help to one to recognize the problem and choose the best method of solving it. Percutaneous interventions applied to treat complications associated with endovascular AAA repair seem to be the best way of treating this condition.

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