Access complications during endovascular aortic repair.

Area of Science:

• Vascular Surgery
• Interventional Radiology

Background:

• Endovascular repair is the primary treatment for aortic aneurysms.
• Access-related complications significantly impact endovascular repair success, leading to morbidity and mortality.

Purpose of the Study:

• To review access-related complications in endovascular aortic repair.
• To discuss diagnostic and therapeutic strategies for managing these complications.

Main Methods:

• Discussion of preoperative imaging importance.
• Review of intraoperative techniques like iliac artery angioplasty/stenting and "pull-down" technique.
• Exploration of alternative access routes (aorta, carotid artery) and percutaneous techniques.

Main Results:

• Preoperative imaging is crucial for successful endovascular procedures.
• Various techniques and alternative access routes can overcome anatomical challenges.
• Peri-operative complications require specific management strategies.

Conclusions:

• Improving stent graft technology and surgical expertise reduce the exclusion of patients due to access issues.
• Effective management of access complications enhances outcomes for endovascular aortic repair.