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Complications of endovascular repair include but are not limited to access artery injury, such as dissection or rupture, and microembolization to distal arteries including the renals, which may lead to renal infarction and/or renal failure, the mesenteric arteries, causing ischemia or gangrene of the bowel, and to the extremities, causing blue toe syndrome (a painful condition affecting the toes and causing color changes, blisters, skin loss, and gangrene). Other complications include groin hematoma, seroma, or lymphocele; groin incision infection; and/or dehiscence.

• Postimplantation syndrome may occur in up to 50% of patients undergoing EVAR and is characterized by a fever of up to 40°C, leukocytosis, general malaise, depression, and back pain due to thrombosis in the aneurysm sac.
• Endoleak is a failure to exclude the aneurysm sac fully from the arterial circulation. If the sac remains pressurized, it may require additional interventions, such as embolization or open repair. Endoleaks are classified as type I, at the attachment site; type II, retrograde into the sac via a lumbar artery or the IMA; type III, fabric tear; type IV, ooze through the fabric; and type V, endotension where the sac continues to be pressurized and grow but the endoleak cannot be found.