Details

Autor(en) / Beteiligte

• Hallett, John W.
• Marshall, Donna M.
• Petterson, Tanya M.
• Gray, Darryl T.
• Bower, Thomas C.
• Cherry, Kenneth J.
• Gloviczki, Peter
• Pairolero, Peter C.

Titel

Graft-related complications after abdominal aortic aneurysm repair: Reassurance from a 36-year population-based experience

Ist Teil von

• Journal of vascular surgery, 1997-02, Vol.25 (2), p.277-286

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

1997

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Purpose: Graft-related complications must be factored into the long-term morbidity and mortality rates of abdominal aortic aneurysm (AAA) repair. However, the true incidence may be underestimated because some patients do not return to the original surgical center when a problem arises. Methods: To minimize referral bias and loss to follow-up, we studied all patients who underwent AAA repair between 1957 and 1990 in a geographically defined community where all AAA operations were performed and followed by a single surgical practice. All patients who remained alive were asked to have their aortic grafts imaged. Results: Among 307 patients who underwent AAA repair, 29 patients (9.4%) had a graft-related complication. At a mean follow-up of 5.8 years (range, <30 days to 36 years), the most common complication was anastomotic pseudoaneurysm (3.0%), followed by graft thrombosis (2.0%), graft-enteric erosion/fistula (1.6%), graft infection (1.3%), anastomotic hemorrhage (1.3%), colon ischemia (0.7%), and atheroembolism (0.3%). Complications were recognized within 30 days after surgery in eight patients (2.6%) and at late follow-up in 21 patients (6.8%). These complications were observed at a median follow-up of 6.1 years for anastomotic pseudoaneurysm, 4.3 years for graft-enteric erosion, and 0.15 years for graft infection. Kaplan-Meier 5- and 10-year survival free estimates were 98% and 96% for anastomotic pseudoaneurysm, 98% and 95% for combined graft-enteric erosion/infection, and 98% and 97% for graft thrombosis. Conclusions: This 36-year population-based study confirms that the vast majority of patients who undergo standard surgical repair of an abdominal aortic aneurysm remain free of any significant graft-related complication during their remaining lifetime. (J Vasc Surg 1997;25:277-86.)