DIFFICULTIES AND COMPLICATIONS OF TRANSFE MORAL IMPLANTATION OF STENTGRAFTS FOR TREATMENT OF ABDOMINAL AORTIC-ANEURYSM

Between August 31st, 1994 and January 31st 1996, 69 patients received transfemoral application of stentgrafts for treatment of AAA. Only 10 patients received tube grafts in contrast to 59 bifurcated grafts, whi ch were assembled within the aortic lumen. All aneurysms were symptoma tic, growing or sacciform. Risk factors seemed to be aggravated in com parison to conventional operations. 59 operations were technically suc cessful, three were converted to open laparotomy, because of technical malfunction twice and misplacement once. 5 postoperative deaths occur red from multiorgan failure. 7 patients were discharged with primary p ersisting leakage. All patients exhibited reactions to the stentgraft deployment, which mainly referred to the clotting system and/or arteri al pressure. Postoperatively nearly all patients presented a ''post-im plantation syndrome'' over days up to 4 weeks. The observed difficulti es and complications can be attributed in part to a ''learning curve'' , in part to difficult anatomic situtations, which we included in our series. During follow up at 3, 6 and 12 months 7 secondary leakages we re observed, three times because of a documented desintegration, once because of suspected beginning desintegration at a stent-graft junctio n, and three times because of possible failure of graft material. The leakages could be repaired by interventional procedures.