Outcome and Complications of EVAR in Cases of Infrarenal Abdominal Aortic Aneurysm

Introduction: Endovascular repair of infrarenal AAA is rapidly uprising as the favorite modality of treatment that probably may replace the classic competitor which is the open repair. Yet, it still needs to be properly analyzed and evaluated from different scopes. In spite of clearly showing less perioperative mortality and morbidity but the long term results and late sequels of graft insertion is an issue that needs further studies with longer periods of follow-up and strict radiologic surveillance, especially that the need for reintervention should be considered and put in mind. Methods: During the period between January 2012 and October 2013, we treated 15 patients having infrarenal AAA 5cm. Every patient was checked to ensure the suitability for EVAR in terms of aneurysm anatomy and general medical condition. Evaluating the outcome focused on a primary endpoint which is the technical success. Other end points included mortality and procedure-related complications both in the perioperative 30-day period and through a 6-months follow-up interval. Results: Technical success was achieved in 100% of cases. The perioperative aneurysm-related mortality was 1/15 (6.7%). In the 6-months follow-up there were no other deaths of any cause. The overall complication rate was 5/15 (33.3%). Systemic complications occurred in two cases (myocardial infarction and elevated serum creatinine) (13.3%). There were two graft-related complications both of which were Type II endoleak, where one of them was in the peri-operative period, while the other was late. Conclusion: EVAR is an excellent solution for treatment of infrarenal AAA with high success rates. However, graft related complications and late aneurysm-related mortality may need further evaluation in the prospective of the study sample size and the follow-up period.