Management of complications after EVAR and TEVAR

The volume treats the wide diffusion of the endovascular techniques in the treatment of different diseases involving the thoracic (TEVAR) and abdominal aorta (EVAR), which represent a great revolution in vascular surgery. On the other hand they have led to the birth of a new category of patients: those affected by early and late complications after EVAR and TEVAR.
Since their appearance, the management of these patients seemed to be complex and technically demanding. As for traditional surgery, redo procedures require a high level of expertise and skill. However, from both randomized controlled trials and large single-center experiences, it appeared soon evident the much higher rate of reintervention after endovascular procedures than open repair. So it leads to a very large number of patients who need a new treatment during their follow-up.
Fortunately the majority of these complications can be successfully managed with a new endovascular procedure. Furthermore, the Type II endoleak, once indicated as the Achille’s heel of EVAR, is losing its importance, although it is gaining even more popularity. And again, new materials and devices are expected to reduce the rate of complications over time.
Contents
ERRORS AND MISTAKES
EVAR and TEVAR: wrong plannin g of the procedure
Access -related complication after surgical approach
Complications of percutaneous access
Cost implications and legal troubles
Contrast -induced nephropat hy
Errors and mistakes during the follow-up
EVAR and cancer: possible mistakes in the timing
THORACIC AORTA: EARLY COMPL ICATIONS
Deployment failures complicating aortic branches
Stroke and cerebral embolism
Retrograde ascending aortic dissection
Spinal cord ischemia
Complications following treatment of acute and chronic dissections
THORACIC AORTA: LATE COMPL ICATIONS
Bronchoesophageal aortic fistula
Graft infection
Delayed graft dislocation
Delayed aneurysm rupture
ARCH AND THORACO-ABDOMINAL COMPL ICATIONS
Complications during aortic arch hybrid procedure
Complications during thoraco-abdominal hybrid procedures
Branched thoraco-abdominal endograft: early and late complications
Use of multilayer stent : pro and contra
EVAR: EARLY COMPL ICATIONS
Deployment failures compromising renal or hypogastric arteries
Intraoperative arterial rupture
Early endoleak
Colonic ischemia
Spinal cord ischemia
Narrow aortic bifurcation
Post implantation syndrome
EVAR: LATE COMPL ICATIONS
Graft dislocation and migration
Iliac stenosis , kinking and thrombosis
Late endoleak
Aneurysm sac behavior
Delayed aneurysm rupture
Graft infection
Fenestrated and branched endograft: early and late complications
EVAR and TEVAR: EVIDENCE BASED MEDICINE AND PERSPECTIVES
Complications following EVAR and TEVAR: data from Literature
New EVAR devices should reduce early and late complications
TEVAR and EVAR: the new skyline
CONTEMPORARY EXPERIENCES
Introduction of Dyna CT during EVAR: is the daily clinical-practice read y to be changed? A preliminary report from a high-volume vascular center
Do anatomical and clinical features affect EVAR results ?
Study of proximal aortic neck: A comparison of methods (CT-Angiogra phy-IVUS)
Combination of severe peripheral obstructive arteriopathy and abdominal infra-rena l aorta aneurysm in patients undergoing EVAR
Minimally invasive aortic surgery: the role of anesthesia
Per cutaneous Endo Vascular Aortic aneurysm Repair (P-EVAR) vs Open Femora l Access (O-EVAR). A prospective, non-randomized, comparative study and review of the literature
Accidental coverage of renal arteries during EVAR: different salvage techniques for different endografts
Endovascular treatment of isolated bilateral iliac aneurysms preserving anterograde blood flow to one internal iliac artery: an original approach
Lights and shadows in the endovascular treatment of hypogastric aneurysms
Rare and fatal complication after EVAR: diffused visceral microembolization
Post -implantation syndrome following EVAR: analysis of predictive factors of occurrence and evaluation of its role on early and late outcomes
Ruptures after EVAR: conversion or ne w endovascular treatment ?
The role of three -projection completion angiogram to identify endograft limb stenosis after EVAR
Trans-catheter thrombolysis and endovascular relining to treat acute stent graft limb occlusion: technical report
Searching for a role for hemodynamic to explain the behavior of the aneurysmatic sac after endovascular repair
Intrasac coils and fibrin glue injection during EVAR to prevent type II endoleak
Emergent endovascular treatment of secondary aorto-enteric fistula: “bridge” or “definitive ” treatment ?
An unusual late complication after endovascular treatment of aorto-iliac aneurysm with branched endograft
Diagnosis of mesenteric ischemia with laparoscopy in patients with aortic dissection
Open surgical rescue after visceral ischemia following staged endovascular repair of thoracoabdominal aortic aneurysm
A case of massive embolization during endovascular exclusion of a thoracic penetrating aortic ulcer
Misdeployment of a renal stent during fevar : how to manage it?
Predictors and outcomes of acute kidney injury after TEVAR
Neurological monitoring during total aortic arch de branching and aneurysm exclusion: the subclavian debate
Surgical treatment of compression effects of huge ruptured descending thoracic aortic aneurysms treated with endovascular repair