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Related Experiment Videos

Late complications after aortic surgery

N Browning1, R Barry, C Nel

  • 1Bill Venter Unit for Vascular Surgery, Department of Surgery, University of the Orange Free State, Bloemfontein, South Africa.

Annals of Vascular Surgery
|May 1, 1994
PubMed
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Aortic surgery complications like false aneurysms and ureteric obstruction are more common than previously thought. Intravenous peripheral digital subtraction angiography (IVDSA) with completion excretory urography (CEU) effectively detects these issues.

Area of Science:

  • Vascular Surgery
  • Radiology
  • Medical Imaging

Background:

  • Complications after aortic surgery, including false aneurysms, anastomotic stenoses, and ureteric obstruction, are generally considered infrequent.
  • Intravenous peripheral digital subtraction angiography (IVDSA) combined with completion excretory urography (CEU) offers a potentially more sensitive method for long-term complication detection.

Purpose of the Study:

  • To determine the incidence of anastomotic aneurysms, stenoses, and ureteric obstruction post-aortic surgery.
  • To identify predisposing local and systemic factors for these complications.
  • To assess the efficacy of IVDSA as a standalone diagnostic tool for these post-surgical complications.

Main Methods:

  • Forty-four patients who previously underwent aortic surgery (1-12.3 years prior) were evaluated.

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  • Intravenous peripheral digital subtraction angiography (IVDSA) and completion excretory urography (CEU) were performed on all participants.
  • Radiological findings were analyzed to identify specific complications and associated risk factors.

    • Main Results:

    • False aneurysms were detected at 10 distal anastomoses (11.2% anastomotic incidence, 15.9% patient incidence).
    • Endarterectomy and femoral artery anastomosis site were linked to anastomotic aneurysms; 8 aortic anastomoses (18%) showed aneurysms.
    • Hypercholesterolemia was a significant factor (62.5%) in aneurysm development. Three asymptomatic ureteric obstructions were found in patients with prior emergency surgery for ruptured aneurysms.

    Conclusions:

    • The incidence of anastomotic aneurysms and ureteric obstruction after aortic surgery may be higher than previously reported, necessitating careful follow-up.
    • IVDSA with CEU demonstrates potential as a simple and effective imaging method for diagnosing these long-term complications.
    • Identifying risk factors like hypercholesterolemia and specific surgical techniques is crucial for patient management.