Treatment of complications after endovascular repair for abdominal aortic aneurysms: a single center experience

Objective To survey the clinical results of endovascular repair for abdominal aortic aneurysm, and to discuss the reasons and treatment experiences of complications after surgery. Methods 70 patients with infrarenal abdominal aortic aneurysms were treated by endovascular repair and followed up, these clinical data were retrospectively analyzed. Results 68 cases of the endovascular aortic repair (EVAR) were successfully implemented, primary technical success rate was 97.1%. 2 patients accepted the additional surgeries for persistent endoleaks after EVAR. 3 patients(4.3%) died in a month, respectively for upper gastrointestinal hemorrhage, multiple organ failure and cerebral infarction. 10 cases (14.3%, 7 with typeⅠa, 1 with typeⅠb, 2 with typeⅡ) of primary endoleaks after surgery occurred, 2 patients (2.9%, 1 with typeⅠa, 1 with type Ⅰb) received secondary surgery respectively after 3 days and 6 months, the endoleaks of the rest 8 patients disappeared spontaneously on follow-up. There were 4 cases(5.7%) of secondary endoleaks after surgery, all of them were eliminated by coil embolism and covered-stent. 18 cases (25.7%) of gluteus claudication occurred, all of them were relieved by drug therapies including vascular dilation and platelet aggregation inhibitor. Low limb ischemia was observed in 2 cases (2.9%) on operation side, one was cured by bypass, the other patient left hospital spontaneously. All cases were followed up for 2 to 66 months (mean 7.9±12.8 months), 5 cases (7.1%) died in 1 year; 7 cases (17.5%) died in 3 years. Conclusion The aneurysmal sac enlargement owing to instant endoleak is the most dangerous complication in short and midterm follow-up period of EVAR for AAA. Early detection and solution for the potential risk factors will effectively improve the long-term survival rate. Key words: Abdominal aortic aneurysm; Endovascular repair; Endoleak; Complication