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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

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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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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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Open Surgical Conversion After Failed Endovascular Aneurysm Sealing.

Sven R Mathisen1, Simen Tveten Berge1,2

  • 1Department of Vascular Surgery, Innlandet Hospital Trust, Hamar, Norway.

Vascular Health and Risk Management
|June 19, 2025
PubMed
Summary

Open surgical conversion (OSC) after failed Endovascular Aneurysm Sealing (EVAS) shows high technical success. Elective OSC procedures yield better outcomes than emergency conversions, emphasizing surveillance and patient selection for improved results.

Keywords:
EVASEVAS failureendoleakopen surgical conversionsecondary AAA rupturesecondary intervention

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Area of Science:

  • Vascular Surgery
  • Endovascular Interventions
  • Aneurysm Treatment

Background:

  • Endovascular Aneurysm Sealing (EVAS) is an alternative to open repair for abdominal aortic aneurysms.
  • Failure of EVAS endografts necessitates further intervention, often Open Surgical Conversion (OSC).

Purpose of the Study:

  • To evaluate the early and late outcomes of Open Surgical Conversion (OSC) following Endovascular Aneurysm Sealing (EVAS) failure.
  • To assess surgical technique, morbidity, and mortality associated with OSC after EVAS.

Main Methods:

  • Retrospective observational cohort study of 46 patients undergoing OSC after EVAS failure.
  • Primary endpoints: technical procedural success and 30-day mortality.
  • Secondary endpoints: complications and primary prosthesis patency.

Main Results:

  • Technical success rate for OSC was 97.8%.
  • 30-day mortality was 10.9% for elective and 75% for acute OSC.
  • Median survival was 4.2 years; 69.6% of patients were alive with patent prostheses at 4.7 years.

Conclusions:

  • Open surgical conversion is a viable option for failed EVAS, with better outcomes in elective cases.
  • Enhanced surveillance and multidisciplinary patient selection are crucial for optimizing OSC outcomes.