1. Complications of the Access Routes
- Frequency: 9-16 % of all patients
- injuries to the access vessels with or without acute thrombosis, bleeding complications; later also pseudoaneurysm formation and arteriovenous fistulas
- particularly in narrow, delicate or highly tortuous, calcified vessels
- dissection, occlusion of the access vessel, vessel rupture → stent implantation
- bleeding complication at the puncture site (5-8 %) → predominantly conservative; surgical haematoma evacuation with oversewing of the vessel required in < 3 % of cases
Prophylaxis:
- careful patient selection and preprocedural evaluation
- correct selection of the introducer set
2. Misplacement of the Endoprosthesis
placement too distal:
- inadequate proximal sealing → type I endoleak
- proximal extension with an additional stent graft or bare-metal stent
placement too proximal:
- interventional therapy is no longer possible (frequently) → conversion to open surgery
inadequate sealing of the PAU:
- endograft extension
Endoleak:
modelling by means of a balloon, if necessary central and/or peripheral extension
Prophylaxis:
- careful preprocedural evaluation
- familiarise oneself with the various markings on the endograft