Ces radiol. 2023, 77(1):7-11 | DOI: 10.55095/CesRadiol2023/001

Late complications after stent-graft implantation for abdominal aortic aneurysm in patients followed for ten or more yearsOriginal article

Marie Černá¹, Martin Köcher¹, Petr Utíkal², Petr Dráč², Vojtěch Prášil¹

¹ Radiologická klinika LF UP a FN, Olomouc

² II. chirurgická klinika LF UP a FN, Olomouc

Aim: To evaluate the importance of long-term follow-up of patients after stentgraft implantation for abdominal aortic aneurysm in terms of the incidence oflate complications.

Methods: From 1996 to 2021, 649 patients with aneurysms of the abdominal aortaand iliac arteries were treated endovascularly at our institution. Sixty-ninepatients were followed ten or more years after stent graft implantation, 61men and 8 women aged 50 to 81 years, the average age was 67 years. Patientswere followed up with CT angiography and an X-ray of the stent graft skeletonat one-year intervals. Follow-up duration was 10-22 years, mean follow-up was14 years, median was 13 years.

Results: During follow-up in a group of 69 patients, 29 complications (42%)were detected in 22 patients (31%), which were indicated for treatment. In 8(11.5%) patients type II endoleak without enlargement of the aneurysm sac werediagnosed, i.e. without indication for therapy. Twenty-nine late complicationsoccurred in 1 to 18 years after stent graft implantation, 6 in less than 5years, 12 complications in 5-10 years. Eleven complications in more than 10years (18%), of which 9 complications in 7 patients who had no complicationsin the first 5 years and reduced or stationary sac aneurysm. One patient hadstent graft migration, 4 patients had migration and Ia endoleak, 3 had Ibendoleak, 8 patients had type III endoleak, 3 had type II endoleak with aneurysm sac growth, 5 hadendotension, and two patients had iliac limb thrombosis, stent graftthrombosis in one, and abscess in the retroperitoneum in 2 patients. Mostcomplications were indicated for endovascular treatment.

Conclusion: Late complications after stent graft implantation for abdominalaortic aneurysm at risk of aortic rupture can occur at any time duringfollow-up, even in patients who had no complication in the first five yearsafter implantation and even had a reduced aneurysm sac. Long-term follow-up ofpatients after endovascular treatment of abdominal aortic aneurysm istherefore essential, and patients cannot be excluded from follow-up.

Keywords: abdominal aortic aneurysm, endovascular repair, late complications,surveillance

Published: March 1, 2023  Show citation