Endovascular surgery is a recently developed technique used to treat aneurysms, which are small, weakened areas in the walls of blood vessel that balloon outward from the blood vessel. In contrast to the alternate treatment of open surgery, endovascular surgery treats aneurysms through a small incision in the femoral artery, which greatly reduces the recovery time for the procedure. Instead of surgically repairing the aneurysm, doctors feed a narrow tube into the incision in the femoral artery and through the blood vessels to place a graft on the inside of the blood vessel wall at the aneurysm site. While endovascular surgery reduces recovery time, it does carry the risk of several complications.
Endoleak
A common complication of endovascular surgery is endoleak, which is the leaking of blood through the graft, causing the aneurysm to gradually fill with blood again, explains an article published in March-April 2004 issue of "Current Surgery." Due to this risk of endoleak, patients undergoing endovascular surgery often require follow-up exams, including x-rays and monitoring, every four to six months. Follow up may even be required for the rest of the patient's life, according to the Peripheral Vascular Surgery Society. Other complications with the graft may also result, including fracturing of the graft or displacement.
Infection
Infection at the incision site is another possible complication, explains the University of California-San Fransisco Medical Center. This infection may lead to a temporary fever and increased numbers of white blood cells after the surgery.
Aneurysm or Artery Rupture
In rare cases, more serious complications may occur after endovascular surgery, including rupture of the aneurysm. The occurrence of aneurysm rupture is generally 1 percent or less, according to a study conducted at New York Methodist Hospital and published in the March-April 2004 volume of "Current Surgery."
Blocked Blood Flow
Endovascular surgery carries the additional risk of blocked blood flow through the artery. In rare cases, the graft may completely block blood flow through an artery. In 4 to 8 percent of surgeries, the graft inadvertently reduces blood flow to the abdomen or legs, according to the New York Methodist Hospital study.
General Surgery Risks
Endovascular surgery, like any type of surgery requiring anesthesia, carries risks associated with the anesthesia. These possible complications include breathing problems following the surgery, formation of blood clots in the legs, stroke, heart attack and infection of the abdomen, lungs or urinary tract.
Additional Risks
Endovascular surgery also carries a 6 to 28 percent risk of severe bleeding, requiring a blood transfusion, reports the study in Current Surgery. Some patients may have reactions to the tracing dye used in the procedure, which can cause kidney damage in up to 5 percent of surgeries. In other rare cases, nerves surrounding the incision site may become damaged, leading to pain or numbness in the leg, according to MedlinePlus, a service of the National Institutes of Health.
References
- University of California-San Fransisco Medical Center: Endovascular Surgery
- Peripheral Vascular Surgery Society: Endovascular Surgery
- "Current Surgery"; Complications of Endovascular Surgery for Abdominal Aortic Aneurysms; Marcus D'Ayala et al, March-April 2004
- MedlinePlus: Aortic Aneurysm Repair - Endovascular
- MayoClinic.com: Endovascular (Stent-Graft) Surgery for Aortic Aneurysm
