Graft-related complications after abdominal aortic aneurysm repair: reassurance from a 36-year population-based experience

J Vasc Surg. 1997 Feb;25(2):277-84; discussion 285-6. doi: 10.1016/s0741-5214(97)70349-5.


Purpose: Graft-related complications must be factored into the long-term morbidity and mortality rates of abdominal aortic aneurysm (AAA) repair. However, the true incidence may be underestimated because some patients do not return to the original surgical center when a problem arises.

Methods: To minimize referral bias and loss to follow-up, we studied all patients who underwent AAA repair between 1957 and 1990 in a geographically defined community where all AAA operations were performed and followed by a single surgical practice. All patients who remained alive were asked to have their aortic grafts imaged.

Results: Among 307 patients who underwent AAA repair, 29 patients (9.4%) had a graft-related complication. At a mean follow-up of 5.8 years (range, < 30 days to 36 years), the most common complication was anastomotic pseudoaneurysm (3.0%), followed by graft thrombosis (2.0%), graft-enteric erosion/fistula (1.6%), graft infection (1.3%), anastomotic hemorrhage (1.3%), colon ischemia (0.7%), and atheroembolism (0.3%). Complications were recognized within 30 days after surgery in eight patients (2.6%) and at late follow-up in 21 patients (6.8%). These complications were observed at a median follow-up of 6.1 years for anastomotic pseudoaneurysm, 4.3 years for graft-enteric erosion, and 0.15 years for graft infection. Kaplan-Meier 5- and 10-year survival free estimates were 98% and 96% for anastomotic pseudoaneurysm, 98% and 95% for combined graft-enteric erosion/infection, and 98% and 97% for graft thrombosis.

Conclusions: This 36-year population-based study confirms that the vast majority of patients who undergo standard surgical repair of an abdominal aortic aneurysm remain free of any significant graft-related complication during their remaining lifetime.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm, False / etiology
  • Aortic Aneurysm, Abdominal / mortality
  • Aortic Aneurysm, Abdominal / surgery*
  • Blood Vessel Prosthesis / adverse effects*
  • Blood Vessel Prosthesis / mortality
  • Colon / blood supply
  • Female
  • Fistula / etiology
  • Follow-Up Studies
  • Graft Occlusion, Vascular
  • Hemorrhage / etiology
  • Humans
  • Intestinal Fistula / etiology
  • Ischemia / etiology
  • Male
  • Middle Aged
  • Minnesota / epidemiology
  • Prosthesis-Related Infections
  • Survival Rate
  • Thrombosis / etiology
  • United States / epidemiology