Reinterventions after open and endovascular AAA repair

Area of Science:

• Vascular Surgery
• Medical Devices
• Surgical Outcomes

Background:

• Reintervention rates differ between endovascular aneurysm repair (EVAR) and open surgical repair (OSR).
• Understanding reintervention patterns is crucial for optimizing patient care after aortic aneurysm repair.
• The complexity of the primary procedure influences reintervention incidence, regardless of technique.

Purpose of the Study:

• To review common complications and required reinterventions for both open and endovascular aortic aneurysm repair.
• To compare reintervention rates and types between EVAR and OSR.
• To discuss factors influencing reintervention, including device complexity and procedural specifics.

Main Methods:

• Literature review of common complications and reinterventions following EVAR and OSR.
• Analysis of reintervention rates and indications based on repair type and complexity.
• Discussion of factors affecting reintervention, such as device type and adherence to instructions for use.

Main Results:

• Reinterventions occur more frequently after EVAR (approx. 20%) than OSR (approx. 10%).
• EVAR reinterventions are predominantly endoluminal; OSR has more early reinterventions.
• Limb thrombosis, infections, and endoleaks are the most common indications for reintervention in both techniques.

Conclusions:

• Reintervention patterns vary by repair type, with EVAR requiring more frequent, often less invasive, procedures.
• Procedural complexity, whether open or endovascular, significantly impacts reintervention rates.
• Standardized reporting and analysis of reinterventions are essential for improving aortic aneurysm repair outcomes.