Open Conversion After Endovascular Abdominal Aneurysm Repair: An 8 year Single Centre Experience

I Ben Abdallah¹, S El Batti², M Abou-Rjeili²

¹Service de Chirurgie Cardiaque et Vasculaire-Hôpital Européen Georges Pompidou, Paris, France.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery

|April 11, 2017

Summary

Open conversion (OC) after endovascular aneurysm repair (EVAR) failure is safer when performed electively. Emergency OC significantly increases mortality and morbidity compared to planned procedures, highlighting the importance of timely intervention for EVAR complications.

Area of Science:

Vascular Surgery
Endovascular Interventions
Surgical Outcomes

Background:

Endovascular aneurysm repair (EVAR) is a common treatment for abdominal aortic aneurysms.
Complications and failures of EVAR can necessitate open conversion (OC).
Outcomes of OC after EVAR are not well-defined, particularly comparing elective versus emergency settings.

Purpose of the Study:

To report institutional experience with open conversion (OC) following failed EVAR.
To compare the outcomes of patients undergoing elective OC versus emergency OC.
To identify factors influencing outcomes in patients requiring OC after EVAR.

Main Methods:

Retrospective and observational study of 31 patients undergoing OC after EVAR (August 2008 - September 2016).
Prospective collection of demographic, anatomical, intra-operative, and post-operative data.
Primary endpoints: 30-day and in-hospital mortality. Secondary endpoints: complications, re-interventions, and length of stay.

Main Results:

19 elective and 12 emergency OC procedures were performed.
Most common indications for OC were endoleaks (77%), followed by infection and thrombosis.
In-hospital mortality was 10% overall, significantly higher in the emergency group (25% vs. 0%, p=0.049).
Emergency OC had higher rates of renal and pulmonary complications (42% vs. 5% and 42% vs. 0%, respectively).

Conclusions:

Emergency OC is associated with significantly increased in-hospital mortality and morbidity compared to elective OC.
Elective OC is a safer and effective strategy for managing EVAR failure.
Early intervention for EVAR failure to facilitate elective OC is recommended to improve patient outcomes.

Keywords:

Abdominal aortic aneurysm repair EVAR conversion EVAR explantation Failed EVAR

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Open Conversion After Endovascular Abdominal Aneurysm Repair: An 8 year Single Centre Experience

Area of Science:

Background:

Purpose of the Study:

Main Methods:

Main Results:

Conclusions:

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