Journal of Vascular Medicine & Surgery

Abstract

Open Abdominal Aortic Aneurysm Repair: Detection of Delayed Aneurysmal Complications

Perera KG, Wong Ed and Yasir H

Purpose: Up to 65% of open abdominal aortic aneurysm (AAA) repairs develop para-anastomotic pseudoaneurysms; 14% of these requiring surgery. A further 30% may develop metachronous common iliac artery (CIA) aneurysms with up to 15% being surgically significant. Conventional management is to perform a surveillance scan 5 years post-operatively, yet many of these patients are lost to follow-up. This study evaluates the incidence of such aneurysms in our community and will determine appropriate follow-up practice. Methodology: Patients having undergone open AAA repair at Eastern Health at least 5-years prior to the study date were identified. Deceased patients and those requiring high level nursing care were excluded. Eligible cases were reviewed in clinic and offered CT evaluation where there was no recent scan available. Results: 171 operations were identified between 2003- 2008. 90 (53%) patients were confirmed as deceased; with a further 45 (26%) unable to be contacted. Of the 36 eligible patients, 18 (50%) agreed to participate in clinical assessment with only 9 subsequently attending a review clinic; one of whom passed away prior to scanning. 5(56%) were found to have developed a para-anastomotic aneurysm and 2 (22%) had CIA aneurysms. Conclusions: Despite the limited response rate, the incidence of both para-anastomotic pseudoaneurysms and CIA aneurysms in our experience is significant to warrant closer surveillance. Routine follow-up with imaging should be considered for the detection of delayed aneurysm development.