The complications of<unk>  can be divided into those that are related to the<unk>  procedure and those related to the endograft device. For example, a myocardial infarction that occurs immediately after the<unk>  is normally related to the procedure and not the device. By contrast, the development of an endoleak from degeneration of endograft fabric would be a device-related complication. Durability and problems such as 'endoleaks' may require careful surveillance and adjuvant procedures to ensure the success of the<unk>  or<unk> /hybrid procedure. CT Angiography (CTA) imaging has, in particular, made a key contribution to planning, success, durability in this complex area of vascular surgery. A major cause of complications in<unk>  is the failure of the seal between the proximal, infra-renal<unk>  neck and the<unk>  graft. Risk of this form of failure is especially elevated in adverse or challenging proximal neck anatomies, where this seal could be compromised by unsuitable geometric fit between the graft and vessel wall, as well as instability of the anatomy. New recent techniques have been introduced to address these risks by utilizing a segment of the supra-renal portion of the aorta to increase the sealing zone, such as with fenestrated<unk> , chimneys and snorkels. These techniques may be suitable in certain patients with qualifying factors, e.g., configuration of renal arteries, renal function. However, these are more complex procedures than standard<unk>  and may be subject to further complications. An approach that directly augments the fixation and sealing between the graft and aorta to mimic the stability of a surgical anastomosis is EndoAnchoring. EndoAnchors are small, helically shaped implants that directly lock the graft to the aortic wall with the goal to prevent complications of the seal, especially in adverse neck anatomies. These EndoAnchors may also be used to treat identified leaks between the graft and proximal neck. Procedure related Arterial dissection, contrast-induced kidney failure, thromboembolizaton, ischemic colitis, groin hematoma, wound infection, type II endoleaks, myocardial infarction, congestive heart failure, cardiac arrhythmias, respiratory failure. Device related Endograft migration,<unk>  rupture, graft limb stenosis/kinking, type I/III/IV endoleaks, stent graft thrombosis, or infection. Endoleaks An endoleak is a leak into the<unk>  sac after<unk><unk> . Five types of endoleaks exist: * Type I - Perigraft leakage at proximal or distal graft attachment sites (near the renal and iliac arteries) * Type II - Retrograde flow to the<unk>  sac from branches such as the lumbar and inferior mesenteric arteries. Type II endoleaks are the most common, and least serious type of endoleak. Type II endoleaks do not require immediate treatment, as a portion will resolve spontaneously. * Type III - Leakage between overlapping parts of the stent (i.e., the connection between overlapping components) or rupture through graft material. * Type IV - Leakage through the graft wall due to the quality (porosity) of the graft material. As seen in first-generation grafts, changes in graft material in modern devices have decreased the prevalence of type IV leaks. * Type V - Expansion of the<unk>  sac without an identifiable leak. Also called "endotension". Type I and III leaks are considered high-pressure leaks and are more concerning than other leak types. Depending on the aortic anatomy, they may require further intervention to treat. Type 2 leaks are common and often can be left untreated unless the<unk>  sac continues to expand after<unk> . Spinal Cord Injury Spinal cord injury is a devastating complication after aortic surgery, specifically for thoracoabdominal aortic<unk><unk> ; severe injury could lead to urine and fecal incontinence, paresthesia and even paraplegia. The risk varies between studies with two metanalysis demonstrating a pooled incidence of spinal cord injury 2.2% and 11%. Predictive factors include increasing extent of coverage, hypogastric artery occlusion, prior aortic<unk>  and perioperative hypotension. Spinal cord injury related to aortic<unk>  occurs due to impaired blood flow to the spine after coverage of blood vessels, important to the blood circulation of the spine, namely intercostal- and lumbar arteries. A few methods exist for potentially reversing spinal cord injury, if it arises, elevated blood pressure, increased oxygenation, blood transfusion and cerebrospinal fluid drainage. Cerebrospinal Fluid Drainage Cerebrospinal Fluid Drainage is one of the adjunct methods used to reverse spinal cord injury. With increased drainage of spinal fluid, the intrathecal pressure decreases which allows for increase blood perfusion to the spine, possibly reversing the ischemic injury of the spinal tissue due to lessened blood supply. The benefits of this procedure have been established in open aortic<unk>  and suggested in<unk>  aortic<unk> .
Endovascular aneurysm repair
Endovascular coiling
Endoscopic vessel harvesting
Hemipelvectomy
Electrothermal bipolar vessel sealing
Thrombectomy
Pulmonary thromboendarterectomy
Segmental arterial mediolysis