title: Early complications in endovascular treatment of abdominal aortic aneurysm.
abstract: OBJECTIVE
  The incidence of perioperative complications during endovascular repair of abdominal aortic aneurysm (EVAR) is reported in limited series. The aim of this study is to evaluate a multi-center survey of unexpected intraprocedural critical events of EVAR.
  
  
  METHODS
  A questionnaire relative to intraprocedural complications during EVAR was sent to major vascular surgery divisions in Italy. Eleven answered to the survey. The data obtained are relative to 1696 procedures.
  
  
  RESULTS
  A wide range of incidence of critical events was observed, from a lower value of 2.7% to a higher value of 68.8% (mean 21.16%). The problems relative to the insertion phase of the delivery system were 7.7%. Endoleaks were reported in 5.5% of cases. Stent graft release was problematic in 0.4% of cases and in another 0.4% there was a problem in shaft retrieval. Unintentional coverage of renal or polar arteries occurred in 0.8% of the procedures ; hypogastric arteries were unwillingly excluded in 2.7% of cases. Aortic or iliac artery rupture had an incidence of 0.7% ; arterial dissection occurred in 0.9%, atheroembolism in 0.5%, lower limb ischemia due to graft limb kinks in 0.7% and to occlusion in 0.9%.
  
  
  CONCLUSIONS
  Perioperative critical events represent a serious problem only in few cases of EVAR ; they are common but in many cases not predictable ; in most circumstances they can be easily corrected with adjunctive manoeuvres during the same procedure. There is a highly significant correlation between the total workload and the incidence of critical events ; these do not appear to be related to the learning curve.
authors.affiliation: Institute of Vascular Surgery, University of Milan, Via Commenda 12, 20122 Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Gabrielli
authors.forename: A
authors.initials: A
authors.lastname: Baudo
authors.forename: A
authors.initials: A
authors.lastname: Molinari
authors.forename: M
authors.initials: M
authors.lastname: Domanin
mesh_terms: D017546:Angioscopy; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000628:therapy; D007558:Italy / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000628:therapy; D012307:Risk Factors