UROLOGICAL COMPLICATIONS FOLLOWING AORTOF EMORAL GRAFT IMPLANTATION

After implantation of aorto-femoral grafts, primary ureteral lesions a nd secondary ureteral obstructions are the most important urological c omplications. Surgical repair carried out as quickly as possible, incl uding reanastomosis without tension and covering with a peritoneal pat ch or omentum interposition, seems the best means of preventing second ary complications. In the case of secondary obstructions, the interval between implantation of the graft and the diagnosis of obstruction ha s to be considered. A wait-and-see strategy is justified in the case o f early obstruction without symptoms during the Ist year because of th e high rate of spontaneous remission. Obstructions that appear more th an 1 year after operation or symptomatic obstructions have to be treat ed immediately duodenojejunal stent, percutaneous nephrostomy). If rep eated obstructions after removal of stents or nephrostomies are noted, surgical repair seems to be indicated. Stents or nephrostomies as def initive procedures are appropriate only in patients in whom surgical r evision is not possible or desirable.