[Complications in endovascular repair of abdominal aortic aneurysms: treatment and prevention].
OBJECTIVE
To review the prevention and treatment strategies in the complications after endovascular repair (EVAR) of abdominal aortic aneurysms, retrospectively in a single medical center.


METHODS
From January 2003 to December 2010, clinical data of 344 EVAR cases were analyzed retrospectively, including postoperative period and long-term results. There were 302 male and 42 female patients, with a mean age of (69 ± 8) years. Patients were followed up at 3 months, 6 months, and then every year with abdominal x-ray and spiral CT angiography.


RESULTS
The surgical success rate was 99.7% (343/344). The mortality with elective and emergency surgery was 0.30% (1/334) and 1/10 respectively. The average follow-up time was 3 to 84 months with a mean of 32.9 months. The follow-up rate was 81.8% (279/341). The mortality was 1.1% (3/279), the re-intervention rate was 10.4% (29/279) and the overall complication rate was 12.9% (36/279), including endoleak 5.7% (16/279), stent-graft migration 1.1% (3/279), aneurysm expansion or rupture 5.4% (15/279), limb occlusion 2.5% (7/279) and stent-graft infection 1.4% (4/279).


CONCLUSIONS
EVAR has allowed a minimally invasive approach to aortic pathology. A careful preoperative assessment is the key for EVAR. Endoleak continues to be the major long-term complication of the endoluminal grafting technique, and the major cause for re-intervention. Life-long follow-up is an integral part of EVAR.
Department of Vascular Surgery, Zhongshan Hospital, Institute of Vascular Surgery, Fudan University, Shanghai 200032, China.
Xiao
X
Tang
Wei-guo
WG
Fu
Da-qiao
DQ
Guo
Xin
X
Xu
Bin
B
Chen
Jun-hao
JH
Jiang
Jue
J
Yang
Zhen-yu
ZY
Shi
Ting
T
Zhu
Zhi-hui
ZH
Dong
Yun
Y
Shi
Li-xin
LX
Wang
Yu-qi
YQ
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D057867:Endoleak / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D015607:Stents; D055815:Young Adult