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Management of complications of aortic reconstruction 

Management of complications of aortic reconstruction
Chapter:
Management of complications of aortic reconstruction
Author(s):

Edward Choke

, Robert S. M. Davies

, and Robert Sayers

DOI:
10.1093/med/9780199658220.003.0053
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date: 15 September 2019

Open and endovascular repair of infrarenal abdominal aortic aneurysms (AAAs) are both associated with common and unique complications. Open repair (OR) is associated with the development of late graft complications whose incidence steadily increases with time from index procedure. Para-anastomotic aneurysm formation and graft infection are the commonest graft complications following OR, and can be devastating and often require complex and timely reinterventions. Endovascular aneurysm repair (EVAR) may be complicated by endoleak, endograft migration and infection, thrombosis, and late rupture. Endoleak is the most common complication of EVAR. Type 1 and III endoleaks are associated with late rupture and therefore require reinterventions, whereas a type II endoleak may be treated conservatively in the absence of aneurysm sac expansion. The treatment of type II endoleak is controversial and subject to continuing evolution. This chapter reviews the pathogenesis, diagnosis, and management of complications associated with open and endovascular infrarenal AAA repair.

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