[Difficulties and complications in transfemoral implantation of stent prostheses in infrarenal abdominal aortic aneurysms].

Between August 31st, 1994 and January 31st 1996, 69 patients received transfemoral application of stentgrafts for treatment of AAA. Only 10 patients received tube grafts in contrast to 59 bifurcated grafts, which were assembled within the aortic lumen. All aneurysms were symptomatic, growing or sacciform. Risk factors seemed to be aggravated in comparison to conventional operations. 59 operations were technically successful, three were converted to open laparotomy, because of technical malfunction twice and misplacement once. 5 postoperative deaths occurred from multiorgan failure. 7 patients were discharged with primary persisting leakage. All patients exhibited reactions to the stentgraft deployment, which mainly referred to the clotting system and/or arterial pressure. Postoperatively nearly all patients presented a "post-implantation syndrome" over days up to 4 weeks. The observed difficulties and complications can be attributed in part to a "learning curve", in part to difficult anatomic situations, which we included in our series. During follow up at 3, 6 and 12 months 7 secondary leakages were observed, three times because of a documented desintegration, once because of suspected beginning desintegration at a stent-graft junction, and three times because of possible failure of graft material. The leakages could be repaired by interventional procedures.