Vascular Complications of Endovascular Aortic Aneurism Repair: Short and Long Term Follow-Up

Objective: An intervention is recommended in patients, who present with an infrarenal abdominal aortic aneurysm (AAA) of more than 5.5 cm in diameter. Endovascular repair, which has been carried out more than 20 years provides reduced perioperative mortality rates and shorter intensive care and hospital stay, and less bleeding. However, it is not without complications in the short and long term. Vascular complications constitute a major part of them and may contribute to the mortality and mobidity rates. This study aims to evaluate the incidence of vascular complications of Endovascular Aortic Aneurysm Repair (EVAR) in short and long term. Materials and Methods: This study included 79 consecutive patients, who have undergone endovascular repair for an infrarenal abdominal aortic aneurysm, between June 2000- Jan 2010. The archive files and follow-up data of the patients were analyzed. Demography of patients, aneurysm spesifications, mortality and morbidity rate in short and long term and vascular complications were analyzed. Results: The mean age of the patients were 67.4±2.49 (33-86). The majority of the patients was male (85%). Perioperative mortality was 1.2%. Rupture occurred in a patient (1.2%) during the follow-up. Type I, type II and type V endoleak were present in 5%, 7.2% and 3.7%, respectively. Sac enlargement occured in 8.8% of the patients, whilst 65% of the aneurysm shrinked and 27% stayed stable in diameter. Limb thrombosis occured in 9 (11%) patients, migration in 3 (3.6%) patients and pseudoaneurysm in 1 (1.2%) patient. A conversion to open surgery was carried out for a Type Ia endoleak. The mean follow-up was 26.7 mo (6 mo-10 years). The probability of survival was 91.2%, 82.1% and 70.7% at 1st, 2nd and 4th years respectively. Conclusion: Perioperative mortality and morbidity rates are low following endovascular repair for an AAA. However, it should be noted that follow-up can be troublesome anytime with vascular complications, which may necessitate an interventiom. Therefore, a life-long meticulous follow-up is essential. Although the incidence of vascular complications may be high, not every vascular complication needs to be repaired. Furthermore, many of the complications can be managed by endovascular means with lower rates of mortality and morbidity