Ces radiol. 2012, 66(2):159-165

Late complications and reinterventions after stentgraft implantation for subrenal aortic abdominal aneurysmOriginal article

Marie Černá¹, Martin Köcher¹, Petr Utíkal², Petr Dráč², Petr Bachleda², Stanislav Buřval¹, Jana Zapletalová³

¹ Radiologická klinika FN a LF UP, Olomouc

² II. chirurgická klinika FN a LF UP, Olomouc

³ Ústav lékařské biofyziky, pracoviště biometrie LF UP, Olomouc

Aim: To evaluate the incidence of late complications and reinterventions after endovascular treatment of subrenal abdominal aortic aneurysm with stentgraft.


Material and method. From April 1996 to December 2011 we treated 270 patients with abdominal aortic aneurysm endovascularly with stentgraft implantation at our department. There were 233 men and 37 women aged from 49 to 91 years. The average age was 68.7 years. 204 patients were followed for at least a year after treatment. In these patients incidence of late complications (rupture, migration, endoleak, ischemic complications and inflammatory complications) and reintervention were evaluated.

Results: In a group of 204 patients 25 late complications were found, i.e. 12.3% (25/204) and 21 reinterventions were performed, i.e. 10.3% (21/204). From 25 complications there were endoleak type I 5×, endoleak type II with sac enlargement 3×, endoleak type III 4×, endotension 3×, stentgraft migration 4×, ischemic complications 5× and infection 1×. Type I endoleaks and migrations were treated with cuff implantation and with surgical conversion in 1 patient with migration. Endoleaks III were managed by stentgraft implantation and type II endoleaks with sac enlargement by ligation or embolization of source. Endotension was solved by percutaneous puncture of the aneurysm sac with content aspiration. The stentgraft arm thromboses were managed by thrombectomy 1×, femo-femoral crossover bypass was created 2×, conservative treatment 1× and leg amputation was performed 1×. Stent graft infection was managed by surgical conversion.

Conclusion: Endovascular treatment of abdominal aortic aneurysm is associated with the occurrence of late complications and reintervention in 12.3% and 10.3%, which correlates with literature. Most of these late complications can be managed endovascularly.

Keywords: aortic abdominal aneurysm, stentgraft, late complications, reinterventions

Accepted: May 1, 2012; Published: June 1, 2012  Show citation