Adverse events after endoluminal repair of abdominal aortic aneurysms: A comparison during two successive periods of time

Purpose: The aim of this study was to document the incidence rate of advers e events after endoluminal repair of abdominal aortic aneurysms (AAAs) duri ng two successive periods of time. Methods: One hundred ninety patients (175 men, 15 women; mean age, 72 years ) underwent endoluminal repair of AAAs in a 5 1/2-year period. Adverse even ts were documented prospectively for all the patients throughout this inter val. An adverse event was defined as any of the following events: a death w ithin 30 days, a conversion to open repair, the need for further interventi on (either open or endovascular), the need for hemodialysis, a failure to c ure the ABA, and wound complications. The patients were divided into two gr oups-those who underwent operation in the initial 3-year period (group I; n = 75) and those who underwent operation in the subsequent 2 1/2-year perio d (group II; n = 115). The results were analyzed for total adverse events f or both periods of time and for difference in incidence rates within catego ries of adverse events between the two groups. Results: Eight patients (4.2%) died in the perioperative period. The endolu minal. repair failed in 17 patients (8.9%), which necessitated a primary co nversion to open repair at the original operation. In gs patients, 110 adve rse events occurred. There was no significant difference in the incidence r ates of adverse events in patients in group I (37/75) and group II (51/115) . Apart from primary conversion (P =.007), there was no significant differe nce in the incidence rates of adverse events between group I and group II w ithin the following categories: perioperative (within 30 days) deaths, prim ary conversion, secondary conversion, supplementary endoluminal repair, int ervention for lower Limb ischemia, hemodialysis necessitated, failure to cu re the AAA as a result of persistent endoleak, and wound complications. Conclusion: Despite improvements in technology and increasing experience, a dverse events continue to occur in a relatively high proportion of patients (45%) who undergo endoluminal repair of AAA. Reporting the incidence rates of adverse events provides a more accurate picture of the morbidity rates of the endoluminal method rather than simply listing the procedures as succ esses or failures. The similarity in the incidence rates of adverse events in patients in group I and group II suggests that there we inherent risks i n the endoluminal method rather than iatrogenic complications that occur du ring the learning curve with a new technique.