Risk factors of early and late complications in patients undergoing endovascular aneurysm repair.
OBJECTIVE
to identify pre-operative factors that could predict complications following from transluminal repair of abdominal aortic aneurysms (AAA).


METHODS
during a 5-year period, 96 consecutive patients underwent elective endovascular treatment of a AAA. In all patients, helical CT and/or Magnetic Resonance Imaging (MRI), and plain abdominal roentgenogram were performed at 1, 3, 6, 12, 18, and 24 months and yearly thereafter. Angiography was performed systematically 1 year after the stent-graft implantation, or earlier if helical CT or MRI diagnosed an increase in the maximal transverse diameter or a high flow endoleak.


RESULTS
early (<30 days) morbidity (12%) was significantly increased by pre-operative renal insufficiency (p < 0.01). Early mortality (2%) correlated with ASA score (p = 0.01). Median follow-up was 27 months (range 3-66). Mortality (12%) during follow-up was correlated to the pre-operative coronary status (p = 0.01). A type I endoleak was diagnosed in 18 patients (19%). Common iliac artery diameter was correlated with the presence of type I endoleak (p < 0.001). A type II endoleak was diagnosed in 47 (49%) patients. The diagnostic of type II endoleak was significantly increased (p = 0.001) in patients with pre-operative patent IMA associated with more than four patent lumbar arteries. The anatomic characteristics of the aneurysm were correlated to the additional endovascular procedures during stentgraft implantation (p = 0.01), and to the implantation of a complementary iliac limb extension during follow-up (p = 0.01).


CONCLUSIONS
the risk factors determined by this statistical analysis could help surgeons to select more accurately patients suitable for endovascular treatment.
Haulon
S
S
Department of Vascular Surgery, Hôpital Cardiologique, CHRU de Lille, 59037 Lille Cedex, France. haulon@ccf.org
Devos
P
P
Willoteaux
S
S
Mounier-Vehier
C
C
Sokoloff
A
A
Halna
P
P
Beregi
J P
JP
Koussa
M
M
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome