Early and late conversion from endoluminal to open repair

Conversion from endoluminal to open repair of abdominal aortic aneurysms (AAA) may be primary, at the original operation or secondary, at a subsequent operation. The indications for primary conversion include aortic rupture and migration of an endograft resulting in obstructed blood flow and irreversible twisting of an endograft. The indications for secondary conversion include persistent endoleak, sealed endoleak with continued AAA expansion, apparently successful AAA repair, with continued expansion and the presence of an infected endograft. The technique of conversion varies from standard repair through modified standard repair to supraceliac control, depending on the cause of failure leading to conversion. All conversion procedures expose the patient to an increased risk and are best avoided by careful case selection, accurate sizing, and good procedural technique.