Peripheral Vascular Surgery Society

#19 "ENDOTRASH": THE FATE OF MISDEPLOYED AND ABANDONED ENDOVASCULAR GRAFTS.

Claudie S. McArthur, MD, Michael L. Marin, MD, Larry H. Hollier, MD, Morris D. Kerstein, MD, and Victoria J. Teodorescu, MD

The Mount Sinai Medical Center, New York, NY

Despite careful planning and skillful execution of endovascular grafting procedures, complications occur which could lead to procedure failure. Over a six-year period, 329 endovascular graft devices were inserted to treat 249 patients with aortic and iliac aneurysm (162), occlusion (62), or traumatic lesions (25). In 36 instances, endovascular devices were inadvertently misdeployed in the vasculature, abandoned (in essence, disregarded as "endotrash"), and subsequently excluded by the insertion of a second device to treat the underlying vascular lesions.

	Number patients	Number of misplaced grafts	Endovasc. device†	Reason for Device loss*	Acutely compromised outcome (%)	Delayed complic 2° to abandoned device
Aneurysm	162	31	A(10) B(8) C(1) D(5) E(6) F(1)	A(13) B(2)^	2	0
Arterial occlusive disease	62	2	A	A(2) B(0)	0	0
Arterial Trauma	25	3	A	A(2) B(1)	0	0

† A = balloon-expandable, Parodi type device, B = balloon-expandable iliac occluder,
C = Passager iliac artery extension, D = embolic coils, E = free endovascular stent,
F = PTFE covered stent.
* A = poor localization within target lesion, B = device deployment failure.
^ One patient with a late device failure from metal fatigue.

There were no instances of functioning endograft obstruction, or external compression by an abandoned endovascular device. At a mean follow-up of 34 months, no abandoned excluded endovascular graft has demonstrated signs of intravascular prosthesis infection. Additional follow-up will be necessary to fully determine the long-term fate of non-functioning intraluminal endovascular devices.

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Last Updated 5/28/99