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Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632
Online ISSN 1827-191X
COMPLICATIONS OF ENDOVASCULAR AORTIC REPAIR
Berland T. L., Cayne N. S., Veith F. J.
NYU Langone Medical Center, New York, NY, USA
Endovascular repair is becoming the mainstay of treatment for aneurysmal disease of the abdominal and thoracic aorta. Access related issues comprise a major reason for failure or conversion to open repair and can contribute to a significant amount of morbidity and mortality. This article will discuss a multitude of access related complications and their treatment. Preoperative imaging is paramount to the success of endovascular procedures. Intraoperative adjuncts, such as iliac artery angioplasty/stenting, the “pull-down” technique, and aorto mono iliac/femoral systems will be discussed. Occasionally, challenging iliac or femoral anatomy may preclude access through these vessels and the endovascular specialist may need to gain direct access through the aorta or via the carotid artery. In addition, the advantages and disadvantages of an entirely percutaneous technique will be discussed. Finally, peri-operative complications such as rupture, dissection, pseudoaneurysm and infection will be discussed and various treatment modalities reviewed. As stent graft technology and our own skill sets and experience continue to improve, fewer patients will be refused an endovascular repair based on access issues alone.