Intraoperative, perioperative and late complications with endovascular therapy of aortic aneurysm

To describe the incidence and management of the intraoperative, perioperative and late complications of endovascular aortic aneurysm repair.

Endovascular aneurysm repair was attempted in 130 patients between October, 1995 and January, 2000. Follow-up including computed tomography (CT) was performed in the immediate postoperative period and then at 3, 6, 9 and 12 months and biannually thereafter. The median follow-up period was 20 months.

Intra- and perioperative problems occurred in 26 patients (20%). Conversion to open surgery was required in five cases (4%). The primary technical success rate was 86%. Three patients (2%) died within the first 30 postoperative days. Late problems occurred in 28 patients (26%). These included: endoleaks (type I: 5%; type II: 10%; type III: 1%) and limb occlusion (3%). The cumulative rate of freedom from secondary intervention was in the first 65 patients treated: 86% and 65% after 1 and 3 years, respectively, and in the last 65 patients: 90% at 1 year.

Endovascular aneurysm repair is associated with a higher complication rate than open surgery.