Semin intervent Radiol 2009; 26(1): 003-009
DOI: 10.1055/s-0029-1208377
© Thieme Medical Publishers

Complications after Endovascular Aneurysm Repair

Geert Maleux1 , Marcel Koolen1 , Sam Heye1
  • 1Department of Radiology, University Hospitals Leuven, Leuven, Belgium
Further Information

Publication History

Publication Date:
16 March 2009 (online)

ABSTRACT

Endovascular aneurysm repair (EVAR) has become an established technique for the treatment of many infrarenal aortic aneurysms. Although EVAR is obviously less invasive than open surgical repair, it is not free of complications. These can potentially result in severe morbidity or even mortality, stressing the need for an early detection and subsequent treatment. In this review article, the pathophysiology, diagnosis, and treatment of the most common complications of EVAR, with the exception of endoleaks, are described.

REFERENCES

  • 1 Blankensteijn J D, de Jong S E, Prinssen M et al.. Dutch Randomized Endovascular Aneurysm Management (DREAM) Trial Group. Two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms.  N Engl J Med. 2005;  352 2398-2405
  • 2 Katzen B T, MacLean A A. Complications of endovascular repair of abdominal aortic aneurysms: a review.  Cardiovasc Intervent Radiol. 2006;  29 935-946
  • 3 Liaw J V, Clark M, Gibbs R, Jenkins M, Cheshire N, Hamady M. Update: complications and management of infrarenal EVAR.  Eur J Radiol. 2008;  , July 8 (Epub ahead of print)
  • 4 Golzarian J, Struyven J. Imaging of complications after endoluminal treatment of abdominal aortic aneurysms.  Eur Radiol. 2001;  11 2244-2251
  • 5 Wald R, Waikar S S, Liangos O, Pereira B J, Chertow G M, Jaber B L. Acute renal failure after endovascular vs open repair of abdominal aortic aneurysm.  J Vasc Surg. 2006;  43 460-466
  • 6 Gahlen J, Hansmann J, Schumacher H, Seelos R, Richter G M, Allenberg J R. Carbon dioxide digital subtraction angiography for endovascular grafting in high-risk patients with infrarenal abdominal aortic aneurysms.  J Vasc Surg. 2001;  33 646-649
  • 7 Chao A, Major K, Kumar S R et al.. Carbon dioxide digital subtraction angiography-assisted endovascular aortic aneurysm repair in the azotemic patient.  J Vasc Surg. 2007;  45 451-458
  • 8 Criado E, Kabbani L, Cho K. Catheter-less angiography for endovascular aortic aneurysm repair: a new application of carbon dioxide as a contrast agent.  J Vasc Surg. 2008;  48 527-534
  • 9 Becquemin J P, Majewski M, Fermani N et al.. Colon ischemia following abdominal aortic aneurysm repair in the era of endovascular abdominal aortic repair.  J Vasc Surg. 2008;  47 258-263
  • 10 Perry R J, Martin M J, Eckert M J, Sohn V Y, Steele S R. Colonic ischemia complicating open versus endovascular abdominal aortic aneurysm repair.  J Vasc Surg. 2008;  48 272-277
  • 11 Zhang W W, Kulaylat M N, Anain P M et al.. Embolization as cause of bowel ischemia after endovascular abdominal aortic aneurysm repair.  J Vasc Surg. 2004;  40 867-872
  • 12 Berg P, Kaufmann D, van Marrewijk C J, Buth J. Spinal cord ischaemia after stent-graft treatment for infra-renal abdominal aortic aneurysms. Analysis of the Eurostar database.  Eur J Vasc Endovasc Surg. 2001;  22 342-347
  • 13 Fortes D L, Atkins B Z, Chiou A C. Delayed paraplegia following intrarenal abdominal aortic endograft placement: case report and literature review.  Vascular. 2004;  12 130-135
  • 14 Reid J A, Mole D J, Johnston L C, Lee B. Delayed paraplegia after endovascular repair of abdominal aortic aneurysm.  J Vasc Surg. 2003;  37 1322-1323
  • 15 Garcia N D, Tehrani H, Morasch M, Pearce W, Matsumura J. Spinal cord ischemia following endovascular repair of an infrarenal aortic aneurysm.  Ann Vasc Surg. 2002;  16 509-512
  • 16 Rockman C B, Riles T S, Landis R. Lower extremity paraparesis or paraplegia subsequent to endovascular management of abdominal aortic aneurysms.  J Vasc Surg. 2001;  33 178-180
  • 17 Bajwa A, Davis M, Moawad M, Taylor P R. Paraplegia following elective endovascular repair of abdominal aortic aneurysm: reversal with cerebrospinal fluid drainage.  Eur J Vasc Endovasc Surg. 2008;  35 46-48
  • 18 Kalliafas S, Albertini J N, Macierewicz J et al.. Incidence and treatment of intraoperative technical problems during endovascular repair of complex abdominal aortic aneurysms.  J Vasc Surg. 2000;  31 1185-1192
  • 19 Görich J, Krämer S, Rilinger N et al.. Malpositioned or dislocated aortic endoprostheses: repositioning using percutaneous pull-down maneuvers.  J Endovasc Ther. 2000;  7 123-131
  • 20 van Dijk L C, van Sambeek M R, Cademartiri F, Pattynama P M. Partial blockage of the renal artery ostium after stent-graft placement: detection and treatment.  J Endovasc Ther. 2003;  10 684
  • 21 Fairman R M, Baum R A, Carpenter J P et al.. The Phase II EVT Investigators. . Limb interventions in patients undergoing treatment with an unsupported bifurcated aortic endograft system: a review of the Phase II EVT Trial.  J Vasc Surg. 2002;  36 118-126
  • 22 Amesur N B, Zajko A B, Orons P D, Makaroun M S. Endovascular treatment of iliac limb stenoses or occlusions in 31 patients treated with the Ancure graft.  J Vasc Interv Radiol. 2000;  11 421-428
  • 23 Maleux G, Koolen M, Heye S, Nevelsteen A. Limb occlusion after endovascular repair of abdominal aortic aneurysms with supported endografts.  J Vasc Interv Radiol. 2008;  19 1409-1412
  • 24 Maldonado T S, Rockman C B, Riles E et al.. Ischemic complications after endovascular abdominal aortic aneurysm repair.  J Vasc Surg. 2004;  40 703-710
  • 25 Carroccio A, Faries P L, Morrissey N J et al.. Predicting iliac limb occlusions after bifurcated aortic stent grafting: anatomic and device-related causes.  J Vasc Surg. 2002;  36 679-684
  • 26 Maleux G, Koolen M, Heye S, Heremans B, Nevelsteen A. Mural thrombotic deposits in abdominal aortic endografts are common and do not require additional treatment at short-term and midterm follow-up.  J Vasc Interv Radiol. 2008;  19 1558-1562
  • 27 Sharif M A, Lee B, Lau B B et al.. Prosthetic stent graft infection after endovascular abdominal aortic aneurysm repair.  J Vasc Surg. 2007;  46 442-448
  • 28 van den Berg H R, Leijdekkers V J, Vahl A. Aortic stent-graft infection following septic complications of a kidney stone.  Cardiovasc Intervent Radiol. 2006;  29 443-445
  • 29 Saratzis N, Saratzis A, Melas N, Ktenidis K, Kiskinis D. Aortoduodenal fistulas after endovascular stent-graft repair of abdominal aortic aneurysm: single-center experience and review of the literature.  J Endovasc Ther. 2008;  15 441-448
  • 30 Bergqvist D, Björck M, Nyman R. Secondary aortoenteric fistula after endovascular aortic interventions: a systematic literature review.  J Vasc Interv Radiol. 2008;  19 163-165
  • 31 Parra J R, Lee C, Hodgson K J, Perler B. Endograft infection leading to rupture of aortic aneurysm.  J Vasc Surg. 2004;  39 676-679
  • 32 Baker M, Uflacker R, Robison J G. Stent graft infection after abdominal aortic aneurysm repair: a case report.  J Vasc Surg. 2002;  36 180-183
  • 33 Mita T, Arita T, Matsunaga N et al.. Complications of endovascular repair for thoracic and abdominal aortic aneurysm: an imaging spectrum.  Radiographics. 2000;  20 1263-1278
  • 34 Orton D F, LeVeen R F, Saigh J A et al.. Aortic prosthetic graft infections: radiologic manifestations and implications for management.  Radiographics. 2000;  20 977-993

Geert MaleuxM.D. Ph.D. 

Department of Radiology, University Hospitals Leuven

Herestraat 49, B-3000 Leuven, Belgium

Email: geert.maleux@uz.kuleuven.ac.be

    >