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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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CASE REPORTS VASCULAR SECTION
The Journal of Cardiovascular Surgery 2006 December;47(6):667-70
Early graft thrombosis after endovascular aortic aneurysm repair with aortouni-iliac endografts
Fernández-Alonso L., Olea J.
Division of Vascular Surgery University Clinic of Navarra, Pamplona, Spain
Endovascular repair of aortic aneurysm has become a viable treatment option in selected patients. However, despite the minimally invasive nature ot this treatment a significant incidence of vascular complications has been reported. Here, we report two cases of acute limbs ischemia due to endograft thrombosis in patients treated with aortouni-iliac devices and we review the etiologic factors related with these events and the treatment options. We suggest that the presence of atherosclerotic plaques within the outflow arteries and coexistent infrainguinal arterial occlusive disease (poor runoff) is an underestimated factor in the risk of graft trombosis, especcially in patients treated with aortouni-iliac devices and we invocate the use in the early follow-up surveillance after endovascular repair of aortic aneurysm of noninvasive test such duplex scanning, segmental pressures and ankle-braquial indices to asses the presence or progress of coexistent occlusive disease. We also suggest that some adverse outcomes adscribed to device failure might be more properly charged to inappropiate patient selection.