Late complications from plastic replacement of aortic abdominal aneurysms.

Abstract

DEFINITIVE therapy of aneurysms of the abdominal aorta began to reach a satisfactory state with the development of the freeze-dried aortic homograft. Aside from the nuisance caused by the difficulties in obtaining these grafts, late complications have occurred at a high rate. These include atheroarteriosclerotic changes, thromboses, aneurysmal dilation with threat of rupture, and late infection. Complications due to the homograft appeared more frequently in the femoropopliteal system than in the aorta. Barner and DeWeese, 1 reviewing aneurysmal degeneration of arterial homografts, felt that the reason for this divergence in behavior between the aortic and femoral popliteal systems was due to the fact that the media of the aorta was 70% to 80% elastin, whereas the femoropopliteal segment had 1% to 5% elastin in the media and 10% to 30% elastin in the adventitia. They conclude that if aneurysmal degeneration develops, the graft should be resected and replaced with