ENDOVASCULAR AORTIC ANEURYSM REPAIR AT JOHANNESBURG ACADEMIC HOSPITALS.

BACKGROUND: Abdominal aortic aneurysm (AAA) is a common disease seen in vascular units. AAA is defined as transverse diameter greater than 3 cm and affects men more than women. Endovascular aortic aneurysm repair (EVAR) is increasingly being used to treat AAA. Renal dysfunction, graft-related endoleaks, graft limb occlusion, device migration and delayed aneurysm rupture are possible complications that have been encountered after EVAR.

METHOD: Changes in renal functions after one month, six months and twelve months. The incidence of endoleaks, limb occlusion and re-interventions required.

RESULTS: Total of thirty-six patients had EVAR done from February 2014 to April 2017. There were two patients who had type 2 endoleaks on completion angiograms, these resolved on one month CT scan. Fourteen patients had post-EVAR imaging at 1, 6 and 12 months which showed no endoleaks. Three patients developed iliac limb occlusion and was appropriately managed with fem-fem crossover. Eight patients had preexiting renal impairment with worsening of renal function in one patient (not requiring dialysis). Three patients developed renal impairment after EVAR. Twenty-two patients are waiting for the follow up imaging and few patients missing follow-up blood tests - this data will be added before the congress.

CONCLUSION: The follow-up data demonstrates that EVAR can be performed safely in anatomically suitable patients. The limb occlusion rates are within accepted rates to standard vascular registry. The patients who developed renal dysfunction (Glomerular filtration rate between 50-60ml/min/1.73m2) after EVAR remained static for 12 months.