Technical complications of endovascular abdominal aortic aneurysm repair
Purpose: Results from 34 endovascular repairs of abdominal aortic aneurysms are reviewed to identify technical complications and relate them to anatomic and technical features of the operation. Methods: Twenty-one patients underwent attempted tube graft repair (mean follow-up, 13 months). Thirteen p...
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| Veröffentlicht in: | Journal of vascular surgery 1997-09, Vol.26 (3), p.502-510 |
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| creator | Naslund, Thomas C. Edwards, William H. Neuzil, Daniel F. Martin, Raymond S. Snyder, Stanley O. Mulherin, Joseph L. Failor, Melanie McPherson, Kathy |
| description | Purpose: Results from 34 endovascular repairs of abdominal aortic aneurysms are reviewed to identify technical complications and relate them to anatomic and technical features of the operation.
Methods: Twenty-one patients underwent attempted tube graft repair (mean follow-up, 13 months). Thirteen patients underwent placement of a bifurcated graft (mean follow-up, 7.2 months).
Results: Twenty-five patients (74%) underwent repair without technical complication (16 tube graft and nine bifurcated graft). Of five patients who had tube graft complications, two involved small iliac arteries and resulted in arterial injury. One of these patients needed a femorofemoral bypass procedure, and the other required conversion to standard operation. Two patients had distal leaks associated with the attachment system, and one patient had misplacement of the distal attachment system. The two patients who had leaks were followed-up; one required operation after 7 months, whereas the other leak sealed. The patient who had distal attachment system misplacement had a second endograft placed within the first to provide a distal seal. The four patients who had bifurcated graft complications involved two graft limb stenoses, one managed with a Palmaz stent and the other with balloon angioplasty. The patient treated with balloon angioplasty had graft thrombosis 1 week after the operation, which resulted in the need for a femorofemoral bypass procedure. Another bifurcated graft patient had a graft limb twist, which has resulted in chronic claudication. One patient had placement of a limb too proximal in the common iliac artery with chronic leak, and an open operation was performed 18 months later.
Conclusions: Technical complications in this series seem to be associated with short distal necks, small iliac arteries, tortuous iliac arteries, and atherosclerosis at the aortic bifurcation. We believe that experience and understanding of these issues will reduce the risk of these complications in the future. |
| doi_str_mv | 10.1016/S0741-5214(97)70043-0 |
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Methods: Twenty-one patients underwent attempted tube graft repair (mean follow-up, 13 months). Thirteen patients underwent placement of a bifurcated graft (mean follow-up, 7.2 months).
Results: Twenty-five patients (74%) underwent repair without technical complication (16 tube graft and nine bifurcated graft). Of five patients who had tube graft complications, two involved small iliac arteries and resulted in arterial injury. One of these patients needed a femorofemoral bypass procedure, and the other required conversion to standard operation. Two patients had distal leaks associated with the attachment system, and one patient had misplacement of the distal attachment system. The two patients who had leaks were followed-up; one required operation after 7 months, whereas the other leak sealed. The patient who had distal attachment system misplacement had a second endograft placed within the first to provide a distal seal. The four patients who had bifurcated graft complications involved two graft limb stenoses, one managed with a Palmaz stent and the other with balloon angioplasty. The patient treated with balloon angioplasty had graft thrombosis 1 week after the operation, which resulted in the need for a femorofemoral bypass procedure. Another bifurcated graft patient had a graft limb twist, which has resulted in chronic claudication. One patient had placement of a limb too proximal in the common iliac artery with chronic leak, and an open operation was performed 18 months later.
Conclusions: Technical complications in this series seem to be associated with short distal necks, small iliac arteries, tortuous iliac arteries, and atherosclerosis at the aortic bifurcation. We believe that experience and understanding of these issues will reduce the risk of these complications in the future.</description><identifier>ISSN: 0741-5214</identifier><identifier>EISSN: 1097-6809</identifier><identifier>DOI: 10.1016/S0741-5214(97)70043-0</identifier><identifier>PMID: 9308596</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Aged ; Aorta, Abdominal - diagnostic imaging ; Aorta, Abdominal - surgery ; Aortic Aneurysm, Abdominal - complications ; Aortic Aneurysm, Abdominal - diagnostic imaging ; Aortic Aneurysm, Abdominal - surgery ; Blood Vessel Prosthesis - adverse effects ; Blood Vessel Prosthesis - methods ; Blood Vessel Prosthesis - statistics & numerical data ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Patient Selection ; Postoperative Complications - diagnostic imaging ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Postoperative Complications - surgery ; Reoperation - statistics & numerical data ; Tomography, X-Ray Computed</subject><ispartof>Journal of vascular surgery, 1997-09, Vol.26 (3), p.502-510</ispartof><rights>1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c502t-564cf35e47a02d2cd8478544ac93f36e638150210f329b7c9d1c3a4b379f53e23</citedby><cites>FETCH-LOGICAL-c502t-564cf35e47a02d2cd8478544ac93f36e638150210f329b7c9d1c3a4b379f53e23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0741-5214(97)70043-0$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9308596$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Naslund, Thomas C.</creatorcontrib><creatorcontrib>Edwards, William H.</creatorcontrib><creatorcontrib>Neuzil, Daniel F.</creatorcontrib><creatorcontrib>Martin, Raymond S.</creatorcontrib><creatorcontrib>Snyder, Stanley O.</creatorcontrib><creatorcontrib>Mulherin, Joseph L.</creatorcontrib><creatorcontrib>Failor, Melanie</creatorcontrib><creatorcontrib>McPherson, Kathy</creatorcontrib><creatorcontrib>From the Division of Vascular Surgery, Vanderbilt University Medical Center, and the Department of Surgery, St. Thomas Hospital</creatorcontrib><title>Technical complications of endovascular abdominal aortic aneurysm repair</title><title>Journal of vascular surgery</title><addtitle>J Vasc Surg</addtitle><description>Purpose: Results from 34 endovascular repairs of abdominal aortic aneurysms are reviewed to identify technical complications and relate them to anatomic and technical features of the operation.
Methods: Twenty-one patients underwent attempted tube graft repair (mean follow-up, 13 months). Thirteen patients underwent placement of a bifurcated graft (mean follow-up, 7.2 months).
Results: Twenty-five patients (74%) underwent repair without technical complication (16 tube graft and nine bifurcated graft). Of five patients who had tube graft complications, two involved small iliac arteries and resulted in arterial injury. One of these patients needed a femorofemoral bypass procedure, and the other required conversion to standard operation. Two patients had distal leaks associated with the attachment system, and one patient had misplacement of the distal attachment system. The two patients who had leaks were followed-up; one required operation after 7 months, whereas the other leak sealed. The patient who had distal attachment system misplacement had a second endograft placed within the first to provide a distal seal. The four patients who had bifurcated graft complications involved two graft limb stenoses, one managed with a Palmaz stent and the other with balloon angioplasty. The patient treated with balloon angioplasty had graft thrombosis 1 week after the operation, which resulted in the need for a femorofemoral bypass procedure. Another bifurcated graft patient had a graft limb twist, which has resulted in chronic claudication. One patient had placement of a limb too proximal in the common iliac artery with chronic leak, and an open operation was performed 18 months later.
Conclusions: Technical complications in this series seem to be associated with short distal necks, small iliac arteries, tortuous iliac arteries, and atherosclerosis at the aortic bifurcation. We believe that experience and understanding of these issues will reduce the risk of these complications in the future.</description><subject>Aged</subject><subject>Aorta, Abdominal - diagnostic imaging</subject><subject>Aorta, Abdominal - surgery</subject><subject>Aortic Aneurysm, Abdominal - complications</subject><subject>Aortic Aneurysm, Abdominal - diagnostic imaging</subject><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Blood Vessel Prosthesis - adverse effects</subject><subject>Blood Vessel Prosthesis - methods</subject><subject>Blood Vessel Prosthesis - statistics & numerical data</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient Selection</subject><subject>Postoperative Complications - diagnostic imaging</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - surgery</subject><subject>Reoperation - statistics & numerical data</subject><subject>Tomography, X-Ray Computed</subject><issn>0741-5214</issn><issn>1097-6809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkM1LwzAUwIMoc07_hEFPoodq0iRNcxIZ6oSBB-c5pOkrRtqmJu1g_73ZB7t6eg_e7339EJoT_EAwyR8_sWAk5Rlhd1LcC4wZTfEZmhIsRZoXWJ6j6Qm5RFch_GBMCC_EBE0kxQWX-RQt12C-O2t0kxjX9k3MBuu6kLg6ga5yGx3M2Gif6LJyre0ip50frEl0B6Pfhjbx0Gvrr9FFrZsAN8c4Q1-vL-vFMl19vL0vnlep4TgbUp4zU1MOTGicVZmpCiYKzpg2ktY0h5wWJIIE1zSTpTCyIoZqVlIha04hozN0e5jbe_c7QhhUa4OBpon3uDEoISkhgogI8gNovAvBQ616b1vtt4pgtTOo9gbVTo-SQu0NKhz75scFY9lCdeo6Kov1p0Md4pcbC14FY6EzUFkPZlCVs_9s-ANcY4Ad</recordid><startdate>19970901</startdate><enddate>19970901</enddate><creator>Naslund, Thomas C.</creator><creator>Edwards, William H.</creator><creator>Neuzil, Daniel F.</creator><creator>Martin, Raymond S.</creator><creator>Snyder, Stanley O.</creator><creator>Mulherin, Joseph L.</creator><creator>Failor, Melanie</creator><creator>McPherson, Kathy</creator><general>Mosby, Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19970901</creationdate><title>Technical complications of endovascular abdominal aortic aneurysm repair</title><author>Naslund, Thomas C. ; Edwards, William H. ; Neuzil, Daniel F. ; Martin, Raymond S. ; Snyder, Stanley O. ; Mulherin, Joseph L. ; Failor, Melanie ; McPherson, Kathy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c502t-564cf35e47a02d2cd8478544ac93f36e638150210f329b7c9d1c3a4b379f53e23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Aged</topic><topic>Aorta, Abdominal - diagnostic imaging</topic><topic>Aorta, Abdominal - surgery</topic><topic>Aortic Aneurysm, Abdominal - complications</topic><topic>Aortic Aneurysm, Abdominal - diagnostic imaging</topic><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Blood Vessel Prosthesis - adverse effects</topic><topic>Blood Vessel Prosthesis - methods</topic><topic>Blood Vessel Prosthesis - statistics & numerical data</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient Selection</topic><topic>Postoperative Complications - diagnostic imaging</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - surgery</topic><topic>Reoperation - statistics & numerical data</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Naslund, Thomas C.</creatorcontrib><creatorcontrib>Edwards, William H.</creatorcontrib><creatorcontrib>Neuzil, Daniel F.</creatorcontrib><creatorcontrib>Martin, Raymond S.</creatorcontrib><creatorcontrib>Snyder, Stanley O.</creatorcontrib><creatorcontrib>Mulherin, Joseph L.</creatorcontrib><creatorcontrib>Failor, Melanie</creatorcontrib><creatorcontrib>McPherson, Kathy</creatorcontrib><creatorcontrib>From the Division of Vascular Surgery, Vanderbilt University Medical Center, and the Department of Surgery, St. Thomas Hospital</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Naslund, Thomas C.</au><au>Edwards, William H.</au><au>Neuzil, Daniel F.</au><au>Martin, Raymond S.</au><au>Snyder, Stanley O.</au><au>Mulherin, Joseph L.</au><au>Failor, Melanie</au><au>McPherson, Kathy</au><aucorp>From the Division of Vascular Surgery, Vanderbilt University Medical Center, and the Department of Surgery, St. Thomas Hospital</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Technical complications of endovascular abdominal aortic aneurysm repair</atitle><jtitle>Journal of vascular surgery</jtitle><addtitle>J Vasc Surg</addtitle><date>1997-09-01</date><risdate>1997</risdate><volume>26</volume><issue>3</issue><spage>502</spage><epage>510</epage><pages>502-510</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><abstract>Purpose: Results from 34 endovascular repairs of abdominal aortic aneurysms are reviewed to identify technical complications and relate them to anatomic and technical features of the operation.
Methods: Twenty-one patients underwent attempted tube graft repair (mean follow-up, 13 months). Thirteen patients underwent placement of a bifurcated graft (mean follow-up, 7.2 months).
Results: Twenty-five patients (74%) underwent repair without technical complication (16 tube graft and nine bifurcated graft). Of five patients who had tube graft complications, two involved small iliac arteries and resulted in arterial injury. One of these patients needed a femorofemoral bypass procedure, and the other required conversion to standard operation. Two patients had distal leaks associated with the attachment system, and one patient had misplacement of the distal attachment system. The two patients who had leaks were followed-up; one required operation after 7 months, whereas the other leak sealed. The patient who had distal attachment system misplacement had a second endograft placed within the first to provide a distal seal. The four patients who had bifurcated graft complications involved two graft limb stenoses, one managed with a Palmaz stent and the other with balloon angioplasty. The patient treated with balloon angioplasty had graft thrombosis 1 week after the operation, which resulted in the need for a femorofemoral bypass procedure. Another bifurcated graft patient had a graft limb twist, which has resulted in chronic claudication. One patient had placement of a limb too proximal in the common iliac artery with chronic leak, and an open operation was performed 18 months later.
Conclusions: Technical complications in this series seem to be associated with short distal necks, small iliac arteries, tortuous iliac arteries, and atherosclerosis at the aortic bifurcation. We believe that experience and understanding of these issues will reduce the risk of these complications in the future.</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>9308596</pmid><doi>10.1016/S0741-5214(97)70043-0</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aorta, Abdominal - diagnostic imaging Aorta, Abdominal - surgery Aortic Aneurysm, Abdominal - complications Aortic Aneurysm, Abdominal - diagnostic imaging Aortic Aneurysm, Abdominal - surgery Blood Vessel Prosthesis - adverse effects Blood Vessel Prosthesis - methods Blood Vessel Prosthesis - statistics & numerical data Female Follow-Up Studies Humans Male Middle Aged Patient Selection Postoperative Complications - diagnostic imaging Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Complications - surgery Reoperation - statistics & numerical data Tomography, X-Ray Computed |
| title | Technical complications of endovascular abdominal aortic aneurysm repair |
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