Open Reintervention for Aneurysmal Sac Enlargement after EVAR

Area of Science:

• Vascular Surgery
• Endovascular Surgery
• Aortic Aneurysm Management

Background:

• Endovascular aneurysm repair (EVAR) is a common treatment for abdominal aortic aneurysms.
• Persistent type 2 endoleaks (PT2EL) can lead to continued sac enlargement post-EVAR.
• Late reinterventions are sometimes necessary to manage complications like PT2EL.

Purpose of the Study:

• To describe a surgical technique for late open reintervention.
• To evaluate the feasibility of treating aneurysmal sac re-enlargement due to PT2EL.
• To present outcomes of a specific reinforcement method.

Main Methods:

• Open reintervention was performed in 8 patients with aneurysmal sac enlargement post-EVAR.
• Surgical steps included sac exposure, ligation of aortic branches, and opening the sac for hemostasis.
• Reinforcement was achieved by wrapping the sac with equine pericardium.

Main Results:

• The described surgical technique was successfully applied in 8 patients.
• This approach addresses aneurysmal sac re-enlargement caused by persistent type 2 endoleaks.
• Equine pericardium reinforcement was utilized for sac reinforcement.

Conclusions:

• Late open reintervention is a viable option for managing aneurysmal sac enlargement after EVAR.
• The described technique, including equine pericardium reinforcement, is a feasible treatment strategy.
• This method offers a solution for persistent type 2 endoleaks leading to sac re-enlargement.