Question

Describe various complications of endovascular aneurysm repair of aorta (EVAR) pertaining to the procedure and graft deployment.

Hint:

Close monitoring after EVAR is essential to detect complications like endoleaks or graft migration, which can compromise the success of the procedure.

Answer 1

Step 1: Introduction:
Endovascular aneurysm repair (EVAR) is a minimally invasive procedure used to treat abdominal aortic aneurysms (AAA) and other aortic pathologies. While generally considered safe, EVAR can be associated with several complications related to the procedure and graft deployment.
Step 2: Procedure-related Complications:
- Endoleak: A condition where blood continues to flow into the aneurysm sac despite the presence of the graft, potentially leading to aneurysm expansion. - Migration: The graft may move from its original position, compromising the sealing of the aneurysm and increasing the risk of rupture. - Infection: As with any surgical procedure, there is a risk of infection at the graft or incision site. - Perforation: The catheter or guide wire can cause vessel damage during placement, leading to vessel perforation and hemorrhage. - Contrast-induced nephropathy: The use of contrast agents during the procedure may lead to kidney damage in susceptible patients.
Step 3: Graft-related Complications:
- Graft thrombosis: Blood clot formation inside the graft can obstruct blood flow, leading to graft failure. - Graft rupture: In rare cases, the graft may fail and rupture, requiring emergency surgical intervention.