Salvage of a difficult situation: method for conversion of failed endograft

Complications of endovascular aneurysm repair can be difficult to manage. One of the more difficult situations is conversion to open surgery because of a failed endograft. We describe a technique for conversion that allows the proximal attachment system to remain intact. It may also enable infrarenal clamping of the aorta during the operation. The anastomosis is performed by incorporating the proximal attachment system of the endograft. This technique simplifies both vascular control of the aorta and the necessary reconstruction during creation of the proximal anastomosis. We believe this technique has important advantages when conversion of a failed endograft is required.