Early vascular complications after endovascular repair of aortoiliac aneurysms

The purpose of this study was to estimate the frequency of and review the t reatment options for intraoperative endograft access-related vascular compl ications and early postoperative vascular complications of endovascular rep air for aortoiliac aneuryms (EVAR). Between February 1998 and April 2000, 5 3 patients (46 males, 7 females) with aneurysms of the abdominal aorta (AAA ) and iliac arteries were treated with endovascular grafts (48 AAA, and 5 i liac aneurysms). All procedures were performed using open exposure of the f emoral arteries. One patient with an AAA was converted to open repair (prim ary technical success, 98.1 %). We recorded the need for adjunctive vascula r procedures or intervention to the access arteries (iliofemoral) or the en dograft because of thrombosis or distal embolization. Events were classifie d as either intraoperative, early postoperative (< 30 postoperative days), or late postoperative. Their etiology and treatment were recorded. The resu lts were compared to those from other series reported in the literature and to published registry data. From our results we concluded that the need fo r adjunctive vascular procedures to the iliofemoral arteries at the time of EVAR is significant. These procedures are necessary to either repair damag e to the access arteries from the delivery system or provide a conduit for graft delivery in cases where the access arteries are inadequate. Early pos toperative vascular complications are due to technical factors resulting in residual graft limb stenoses. Both intraoperative and early postoperative vascular complications after EVAR are more common in female patients. These complications can be effectively treated with a variety of open surgical a nd transfemoral endovascular techniques.