Why the study?
Do newer EVAR devices reduce ischemic complications compared to older devices in patients undergoing endovascular abdominal aortic aneurysm repair?
Do newer EVAR devices reduce ischemic complications compared to older devices in patients undergoing endovascular abdominal aortic aneurysm repair?
Newer, lower-profile EVAR devices are associated with a significant decrease in ischemic complications, and simultaneous internal iliac artery embolization can be performed safely without staging.
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May inform device selection and embolization timing in EVAR; hypothesis-generating pending randomized confirmation.
Ischemic complications after endovascular abdominal aortic aneurysm repair (EVAR) are well-recognized and have been reported to be as high as 9%. The goal of our study was to examine the incidence, management, and outcome of ischemic complications at our institution after EVAR and to compare complications according to graft type and time period. This is a retrospective review of all EVARs performed at our institution from 1993 through 2005 (n = 430). EVAR was performed in asymptomatic patients in most cases. Follow-up consisted of a computed tomography scan and office visit at 1, 6, and 12 months and yearly thereafter. Ischemic complications after EVAR have decreased significantly with the advent of lower-profile devices with easier delivery systems and supported limbs. Simultaneous coil embolization of internal iliac artery at the time of EVAR implant does not appear to increase the risk of pelvic or lower-extremity ischemia, can be done safely, and does not need to be staged.
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Maldonado et al. (2007) studied this question.
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