The management of graft limb occlusion following abdominal aortic aneurysm endovascular repair

Abstract

Objective To review our experience in the limb occlusion after abdominal aortic aneurysm endovascular repair (EVAR).Methods From January 2008 to December 2012,305 abdominal aortic aneurysm (AAA) patients were electively treated with bifurcated stent grafts.From 0 to 36 months after EVAR,iliac branches (1.97％) were found occluded 6 males,including Iliac graft distortions in 4 cases.Thrombosis occurred in three branches with distortions.Presentation included rest pain in 1 case,claudication in 4 cases,and asymptomatic in 1 case.Treatment included femoro-femoral bypass in 1 case,iliac branch plugging plus femoro-femoral bypass in 1 case,thrombectomy and stent in 4 cases.Results Operations were successful in all patients.Symptoms of rest pain and claudication cured.These 6 patients were followed-up for 6 to 18 months (10 ± 8 months).5 patients had not lower limb ischemia.Claudication in 1 patient became serious after treatment,the symptom cured after balloon dilation +stenting.Conclusions Iliac graft is one of the main causes distortion for graft limb occlusions after EVAR.Surgical bypass and endovascular treatment are efficient and safe method to treat graft limb occlusion after EVAR. Key words: Postoperative complications ; Stents ; Aortic aneurysm, abdominal ; Graft limb occlusion