Advertisement

My Patient’s Aorta Was Repaired. What Complications Arise from AAA Repair? When Should I Be Concerned About Recurrence?

  • Anne WalkerEmail author
  • Sara Manning
Chapter

Abstract

As the number of patients undergoing abdominal aortic aneurysm (AAA) repair increases, it has become increasingly important for acute care providers to understand the complications associated with these procedures. Both open and endovascular aortic repair (EVAR) techniques are widely used. Patients with history of open AAA repair may present with ischemic colitis, aortoenteric fistula, or graft infection. Patients who have undergone EVAR may present with ischemia or endoleak. Rupture is a known complication of EVAR and requires routine imaging surveillance. Computed tomography (CT) angiography or CT with triple-phase contrast helps evaluate for many AAA repair complications. Vascular surgery consultation, often early, is generally indicated when complications are suspected or discovered.

Keywords

AAA repair EVAR Aortoenteric fistula Graft infection Ischemia Endoleak 

References

  1. 1.
    Chandra V, Trang K, Virgin-Downey W, et al. Management and outcomes of symptomatic abdominal aortic aneurysms during the past 20 years. J Vasc Surg. 2017;66:1679–85. epub ahead of print. PMID: 28619644.CrossRefGoogle Scholar
  2. 2.
    Gupta PK, Brahmbhatt R, Kempe K, et al. Thirty-day outcomes after fenestrated endovascular repair are superior to open repair of abdominal aortic aneurysms involving visceral vessels. J Vasc Surg. 2017;66:1653–8. epub ahead of print. PMID: 28711400.CrossRefGoogle Scholar
  3. 3.
    Aggarwal S, Qamar A, Sharma V, Sharma A. Abdominal aortic aneurysm: a comprehensive review. Exp Clin Cardiol. 2011;16(1):11–5. Spring.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Healy GM, Redmond CE, Gray S, et al. Midterm analysis of survival and cause of death following endovascular abdominal aortic aneurysm repair. Vasc Endovasc Surg. 2017;51(5):274–81.CrossRefGoogle Scholar
  5. 5.
    Greenblatt DY, Greenberg CC, Kind AJ, et al. Causes and implications of readmission after abdominal aortic aneurysm repair. Ann Surg. 2012;256(4):595–605.CrossRefGoogle Scholar
  6. 6.
    Slama R, Long B, Koyfman A. The emergency medicine approach to abdominal vascular graft complications. Am J Emerg Med. 2016;34(10):2014–7.CrossRefGoogle Scholar
  7. 7.
    Hausegger KA, Schedlbauer P, Deutschmann HA, et al. Complications in endoluminal repair of abdominal aortic aneurysms. Eur J Radiol. 2001;32:22–33.CrossRefGoogle Scholar
  8. 8.
    Humphreys WV, Byrne J, James W. Elective abdominal aortic aneurysm operations – the results of a single surgeon series of 243 consecutive operations from a district general hospital. Ann R Coll Surg Engl. 2000;82:64–8.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Behrendt CA, Dayama A, Debus ES, et al. Lower extremity ischemia after abdominal aortic aneurysm repair. Ann Vasc Surg. 2017;45:206–12. epub ahead of print.CrossRefGoogle Scholar
  10. 10.
    Thomas E, Parra BL, Patel S. Post-endovascular aneurysm repair (EVAR) testicular ischemia: a rare complication. Urol Case Rep. 2017;8(14):35–7.CrossRefGoogle Scholar
  11. 11.
    Ke C, Feng Y, Chang C, et al. Extensive spinal cord ischemia following endovascular repair of an infrarenal abdominal aortic aneurysm: a rare complication. J Anesth. 2013;27(6):956–9.CrossRefGoogle Scholar
  12. 12.
    Candell L, Tucker L, Goodney P, et al. Early and delayed rupture after endovascular abdominal aortic aneurysm repair in a 10-year multicenter registry. J Vasc Surg. 2014;6(5):1146–53.CrossRefGoogle Scholar
  13. 13.
    Antoniou G, Georgiadis G, Antoniou S, et al. Late rupture of abdominal aortic aneurysm after previous endovascular repair: a systematic review and meta-analysis. J Endovasc Ther. 2015;22(5):734–44.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.University of Maryland Medical CenterBaltimoreUSA
  2. 2.Department of Emergency MedicineUniversity of Maryland School of MedicineBaltimoreUSA

Personalised recommendations