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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
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Minimally Invasive Open Conversion for Late EVAR Failure.

Francesco Stilo1, Nunzio Montelione1, Vincenzo Catanese2

  • 1Division of Vascular Surgery, University of Campus Bio-Medico, Rome, Italy.

Annals of Vascular Surgery
|October 19, 2019
PubMed
Summary
This summary is machine-generated.

Minimally invasive open conversion (MOC) offers a safe solution for endovascular aortic aneurysm repair (EVAR) failure. This approach addresses complications like endoleaks, demonstrating low short-term risks and acceptable long-term outcomes.

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Area of Science:

  • Vascular Surgery
  • Endovascular Surgery
  • Aortic Aneurysm Repair

Background:

  • Endovascular aortic aneurysm repair (EVAR) is increasingly used, leading to a growing interest in open repair for EVAR failure.
  • Surgical conversion after EVAR can be complex, associated with high mortality and complication rates.

Purpose of the Study:

  • To present institutional experience with minimally invasive open conversion (MOC) for EVAR failure.
  • To detail the technical aspects and outcomes of MOC.

Main Methods:

  • Retrospective analysis of a prospectively maintained database of patients undergoing MOC between May 2014 and June 2018.
  • Indications included endoleaks with sac growth or failed endovascular sealing.
  • MOC involved a small abdominal incision, infrarenal clamping, and partial endograft explantation.

Main Results:

  • Ten patients underwent MOC, with a mean interval of 45.1 months post-EVAR.
  • Indications were primarily type II endoleaks (40%) and type Ia endoleaks (30%).
  • At 30 days, no deaths or reinterventions occurred; major complication rate was 10%. At a mean follow-up of 22.9 months, no reinterventions were reported, with a 20% overall mortality (10% aneurysm-related).

Conclusions:

  • Minimally invasive open conversion (MOC) is a safe surgical option for managing EVAR failure.
  • This approach can mitigate risks associated with traditional open conversion.
  • The presented minimally invasive techniques may improve outcomes for this challenging procedure.