21
Late Outcomes
➤ The SVS recommends treatment of type I endoleaks. (See Table 8)
(1-B)
➤ The SVS suggests treatment of type II endoleaks associated with
aneurysm expansion. (2-C)
➤ The SVS recommends surveillance of type II endoleaks not associated
with aneurysm expansion. (1-B)
➤ The SVS recommends treatment of type III endoleaks. (1-B)
➤ The SVS suggests no treatment of type IV endoleaks. (2-C)
➤ The SVS recommends open repair if endovascular intervention fails to
treat a type I or type III endoleak with ongoing aneurysm enlargement.
(1-B)
➤ The SVS suggests open repair if endovascular intervention fails to
treat a type II endoleak with ongoing aneurysm enlargement. (2-C)
➤ The SVS suggests treatment for ongoing aneurysm expansion, even in
the absence of a visible endoleak. (2-C)
➤ The SVS recommends that follow-up of patients after aneurysm repair
include a thorough lower extremity pulse examination or ankle-
brachial index (ABI). (1-B)
➤ The SVS recommends a prompt evaluation for possible graft limb
occlusion if patients develop new-onset lower extremity claudication,
ischemia, or reduction in ABI after aneurysm repair. (1-A)
➤ The SVS recommends antibiotic prophylaxis to prevent graft infection
before any dental procedure involving the manipulation of the gingival
or periapical region of teeth or perforation of the oral mucosa,
including scaling and root canal procedures, for any patient with an
aortic prosthesis, whether placed by OSR or EVAR. (1-B)
➤ The SVS suggests antibiotic prophylaxis before respiratory tract
procedures, gastrointestinal or genitourinary procedures, and
dermatologic or musculoskeletal procedures for any patient with an
aortic prosthesis if the potential for infection exists or the patient is
immunocompromised. (2-C)
➤ After aneurysm repair, the SVS recommends prompt evaluation for
possible graft infection if a patient presents with generalized sepsis,
groin drainage, pseudoaneurysm formation, or ill-defined pain. (1-A)
➤ The SVS recommends prompt evaluation for possible aortoenteric
fistula in a patient presenting with gastrointestinal bleeding after
aneurysm repair. (1-A)
