Treatment of abdominal aortic aneurysms with transfemoral placement of stent-grafts: complications and secondary radiologic intervention.

Abstract

To determine the rate of complications of transluminally placed endovascular stent-grafts in patients with abdominal aortic aneurysms and to assess efficacy of secondary radiologic intervention. In 28 patients, covered nitinol stents were implanted. Frequency and outcome of complications were evaluated after stent-graft placement (mean follow-up, 8.2 months). In 27 patients, 11 tube and 16 bifurcated grafts were implanted successfully. In one (4%) patient, distal migration of a bifurcated graft necessitated conversion to standard open repair. Technical success rates (successful deployment of the device and complete exclusion of the aneurysm at intraoperative angiography) for bifurcated and tube grafts were 24% (four of 17 patients) and 91% (10 of 11 patients). After surgery, leaks were seen in six bifurcated and five tube grafts. After secondary intervention, the final exclusion rate for bifurcated and tube grafts was 88% (15 of 17 patients) and 100% (11 of 11 patients), respectively; the overall success rate was 93% (26 of 28 patients) for exclusion of aortic abdominal aneurysms. Stent-graft thrombosis necessitated local thrombolysis in one patient. Overlapping of accessory renal arteries occurred in two patients. Complications after stent-graft placement in abdominal aortic aneurysms are frequent. Secondary radiologic intervention is successful in most cases.