Table III.
Details of patients who died during the postoperative course
| Gender | Age, ASA class | Anatomic details and expected technical difficulties | Stent graft | Details of IOAE | Cause of death | |
|---|---|---|---|---|---|---|
| Patients who presented with IOAE | ||||||
| Patient 55 | M | 65 years ASA 4 |
Type IV TAAA >50% stenoses of RRA, LRA, and right CIA Shaggy aorta |
4 fenestrations, Cook | RRA and LRA cannulation failure Graft limb occlusion requiring bilateral thrombectomy and iliofemoral bypasses |
Paraplegia, renal failure, pneumonia |
| Patient 74 | M | 78 years ASA 4 |
Type III TAAA >45-degree aortic angulation >50% stenosis of the CT Two accessory renal arteries Severe iliac tortuosity |
4 visceral branches, one additional branch for temporary elective sac perfusion to prevent spinal cord ischemia, Cook | Sizing error: additional branch placed at the level of overlap between two components | Paraplegia, meningoencephalitis after spinal drain placement |
| Patient 80 | F | 71 years ASA 4 |
Juxtarenal AAA >50% stenosis of SMA Narrowed infrarenal aorta (<18 mm) Short occlusion of left CIA Sharp angulation of aortic bifurcation <7.5 mm EIA |
3 fenestrations, Anaconda | Sizing error RRA cannulation failure and difficult cannulation of SMA |
Bowel ischemia due to SMA stent occlusion MOSF despite splenic artery to SMA transposition |
| Patient 95 | M | 82 years ASA 4 |
Pararenal AAA Shaggy aorta |
3 fenestrations, Cook | SMA cannulation failure requiring a bailout chimney stent for the SMA | Cholesterol embolism syndrome, bowel ischemia SMA and CT patent on control computed tomography scan |
| Patients who had no IOAE | ||||||
| Patient 30 | M | 76 years ASA 4 |
Juxtarenal AAA Shaggy aorta Narrowed infrarenal aorta (<18 mm) |
4 fenestrations, Cook | No IOAE | Cholesterol embolism syndrome, bowel ischemia SMA and CT patent on control computed tomography scan |
| Patient 39 | M | 82 years ASA 3 |
Juxtarenal AAA Floating thrombus in the visceral aorta, severe iliac tortuosity |
3 fenestrations, Cook | No IOAE | Cholesterol embolism syndrome, bowel ischemia SMA and CT patent on control computed tomography scan |
| Patient 42 | M | 71 years ASA 4 |
Suprarenal AAA Narrowed infrarenal aorta (<18 mm) |
3 fenestrations, aortouni-iliac device for narrowed aortic bifurcation, Cook | No IOAE but long procedure | Femorofemoral prosthetic graft infection Developed MOSF despite prosthetic graft replacement by a venous graft |
| Patient 49 | M | 76 years ASA 4 |
Juxtarenal AAA Small (<5 mm) LRA |
3 fenestrations, Cook | No IOAE | Pneumonia, SARS |
| Patient 65 | M | 63 years ASA 2 |
Type IV TAA | 4 fenestrations, Cook | No IOAE | Bowel ischemia, unexplained occlusion of SMA and CT stents at day 1 Developed MOSF despite successful SMA stent thrombectomy and colonic and bowel resection |
AAA, Aortic abdominal aneurysm; ASA, American Society of Anesthesiologists; CIA, common iliac artery; CT, celiac trunk; EIA, external iliac artery; F, female; IOAE, intraoperative adverse event; LRA, left renal artery; M, male; MOSF, multiorgan system failure; RRA, right renal artery; SARS, severe acute respiratory syndrome; SMA, superior mesenteric artery; TAAA, thoracoabdominal aneurysm.