[Endovascular aneurysm repair (EVAR) : Complication management]

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Medical Device Technology

Background:

• Endovascular Aneurysm Repair (EVAR) is a common treatment for abdominal aortic aneurysms (AAA).
• EVAR is associated with a range of potential complications, both during the procedure and in the long term.

Purpose of the Study:

• To comprehensively review the spectrum of complications associated with EVAR for AAA.
• To discuss strategies for minimizing complication incidence and managing observed complications.

Main Methods:

• Review of acute and follow-up complications reported after EVAR procedures.
• Emphasis on patient selection, preprocedural assessment, and availability of interventional tools.
• Discussion of endovascular and open surgical management strategies.

Main Results:

• Acute complications include access vessel injury, endograft malplacement, and postimplantation syndrome.
• Late complications encompass endograft migration, occlusion, kinking, infection, and pseudoaneurysms.
• Most complications can be managed endovascularly, requiring a broad armamentarium of devices.

Conclusions:

• Meticulous patient selection and preprocedural planning are crucial for reducing EVAR complications.
• Endovascular management is preferred for the majority of complications.
• Open surgery may be necessary for specific complex cases; interdisciplinary collaboration is essential for optimal outcomes.