1. Graft-related complications after abdominal aortic aneurysm repair: reassurance from a 36-year population-based experience.
- Author
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Hallett JW Jr, Marshall DM, Petterson TM, Gray DT, Bower TC, Cherry KJ Jr, Gloviczki P, and Pairolero PC
- Subjects
- Adult, Aged, Aged, 80 and over, Aneurysm, False etiology, Aortic Aneurysm, Abdominal mortality, Blood Vessel Prosthesis mortality, Colon blood supply, Female, Fistula etiology, Follow-Up Studies, Graft Occlusion, Vascular, Hemorrhage etiology, Humans, Intestinal Fistula etiology, Ischemia etiology, Male, Middle Aged, Minnesota epidemiology, Prosthesis-Related Infections, Survival Rate, Thrombosis etiology, United States epidemiology, Aortic Aneurysm, Abdominal surgery, Blood Vessel Prosthesis adverse effects
- Abstract
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.
- Published
- 1997
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