CASE REPORTS  VASCULAR SECTION 

The Journal of Cardiovascular Surgery 2006 December;47(6):667-70

Copyright © 2006 EDIZIONI MINERVA MEDICA

lingua: Inglese

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.