Delayed open conversion after endovascular aortic repair.

Area of Science:

• Vascular Surgery
• Endovascular Repair
• Open Surgical Repair

Background:

• Endovascular aortic aneurysm repair (EVAR) is a common treatment for aortic aneurysms.
• Complications or failures of EVAR may necessitate further intervention.
• Delayed open surgical conversion is an option for managing EVAR failures.

Purpose of the Study:

• To evaluate the clinical outcomes of delayed open surgical repair following endovascular aortic aneurysm repair.
• To assess the safety and efficacy of converting failed EVAR to open surgery.

Main Methods:

• Retrospective review of patients undergoing delayed open repair after EVAR (July 2001-December 2017).
• Analysis of patient characteristics, indications for conversion, and timing.
• Evaluation of early (morbidity, mortality) and midterm (survival) outcomes.

Main Results:

• 22 patients (3.3%) underwent delayed open conversion, with indications including endoleaks and endotensions.
• No 30-day mortality was observed.
• Estimated survival rates at 1, 2, 3, 4, and 5 years were 96%, 91%, 86%, 79%, and 57%, respectively.

Conclusions:

• Delayed open conversion after EVAR is a safe procedure with favorable short- and mid-term outcomes.
• Open conversion remains a viable option for patients experiencing EVAR failure, provided careful preoperative assessment.