Delayed open conversion after endovascular abdominal aortic aneurysm: Device-specific surgical approach

E. M. Marone, D. Mascia, G. Coppi, Y. Tshomba, L. Bertoglio, A. Kahlberg, R. Chiesa

Research output: Contribution to journalArticle

Abstract

Objectives: Despite several advances in endoluminal salvage for failed endovascular abdominal aortic repair (EVAR), in our experience an increasing number of cases necessitate delayed open conversion (dOC). Methods: EVAR patients requiring delayed (>30 days) conversion were prospectively collected in a computerized database including demographics, details of aortoiliac anatomy, procedural and clinical success, and postoperative complications. Results: Between 2005 and 2011, 54 patients were treated for aortic stent-graft explantation. Indications included 34 type I and III endoleaks, 13 type II endoleaks with aneurysm growth, 4 cases of material failures, and 3 stent-graft infections. All fit-for-surgery patients with type I/III endoleak underwent directly dOC. Different surgical approaches were used depending on the type of stent-graft. Overall 30-day mortality was 1.9%. Overall morbidity was 31% mainly due to acute renal failure (13 cases). Mean hospitalization was 6 days (range, 5-27 days). Overall survival at mean follow-up of 19 months was 78%. Conclusions: In recent years, the use of EVAR has increased dramatically, including in young patients regardless of their fitness for open repair. dOC after endovascular abdominal aortic aneurysm seems to be a lifesaving procedure with satisfactory initial and mid-term results.

Original languageEnglish
Pages (from-to)457-464
Number of pages8
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume45
Issue number5
DOIs
Publication statusPublished - May 2013

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Keywords

  • Abdominal aortic aneurysm repair
  • Endovascular treatment
  • EVAR
  • Late complications
  • Open conversion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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