1. Complications of Access Routes
- Frequency: 9-16 % of all patients
- Injuries to access vessels with or without acute thrombosis, bleeding complications; later also pseudoaneurysm formation and arteriovenous fistulas
- especially in narrow, delicate or highly tortuous, calcified vessels
- Dissection, occlusion of the access vessel, vessel rupture → Stent implantation
- Bleeding complication at puncture site (5-8 %) → mostly conservative; surgical hematoma evacuation with vessel suturing in < 3 % of cases required
Prophylaxis:
- careful patient selection and preprocedural evaluation
- correct selection of the introducer set
2. Misplacement of the Endoprosthesis
too low placement:
- inadequate proximal sealing → Endoleak Type I
- proximal extension with additional stent graft or bare-metal stent
too high placement:
- interventional therapy is no longer possible (frequently) → conversion to open surgery
inadequate sealing of the PAU:
- Endograft extension
Endoleak:
Modeling using balloon, if necessary central and/or peripheral extension
Prophylaxis:
- careful preprocedural evaluation
- familiarize oneself with the various markings on the endograft