Complications in the endovascular repair of abdominal aortic aneurysms: a risk factor analysis.
OBJECTIVE
to identify risk factors for complications following endovascular repair of abdominal aortic aneurysms (AAAs).


METHODS
endovascular AAA exclusion was attempted in 64 patients. Patient characteristics, anatomic features of the aneurysm, operative technical aspects, and the experience of the teams were correlated with mortality, occurrence of endoleak, and other complications. Perioperative complications were graded following the recommendations of the Ad Hoc Committee on reporting standards. For the assessment of correlation between risk factors and outcomes a logistic regression analysis was used.


RESULTS
complications were observed in 43% of the procedures and were classified as mild (24%), moderate (55%) or severe (21%). American Society of Anaesthesiology (ASA) risk class 3 or 4, and advanced age were independent risk factors for perioperative death and complications. Adjuvant procedures or overstenting of the renal arteries with the uncovered part of the stent were not associated with increased risk of complications. Nevertheless, in four of 24 overstented renal orifices, a renal infarction or ischaemia of the kidney was observed on a postoperative CT scan. Advanced experience was associated with less complications, less endoleaks, and shorter operating time.


CONCLUSIONS
high age and medical co-morbidity were associated with increased risk for perioperative complications and death. Additional perioperative procedures are usually well tolerated. With greater experience in endovascular AAA grafting the incidence of complications and endoleaks decreased.
Cuypers
P
P
Departments of Surgery and Radiology, Catharina Hospital, Eindhoven, The Netherlands.
Nevelsteen
A
A
Buth
J
J
Hamming
J
J
Stockx
L
L
Lacroix
H
H
Tielbeek
A
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D007668:Kidney / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D012086:Reoperation; D012307:Risk Factors; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome