Seventeen Years-Experience of Late Open Surgical Conversion after Failed Endovascular Abdominal Aortic Aneurysm Repair with 13 Variant Devices
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- 作者：Ziheng Wu ; Liang Xu ; Lefeng Qu…
- 关键词：Abdominal aortic aneurysm ; Open surgical conversion ; Endovascular repair
- 刊名：CardioVascular and Interventional Radiology
- 出版年：2015
- 出版时间：February 2015
- 年：2015
- 卷：38
- 期：1
- 页码：53-59
- 全文大小：376 KB
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文摘
Purpose To investigate the causes and results of late open surgical conversion (LOSC) after failed abdominal aortic aneurysm repair (EVAR) and to summarize our 17?years-experience with 13 various endografts. Methods Retrospective data from August 1994 to January 2011 were analyzed at our center. The various devices-implant time, the types of devices, the rates and causes of LOSC, and the procedures and results of LOSC were analyzed and evaluated. Results A total of 1729 endovascular aneurysm repairs were performed in our single center (Nuremberg South Hospital) with 13 various devices within 17?years. The median follow-up period was 51?months (range 9-19?months). Among them, 77 patients with infrarenal abdominal aortic aneurysms received LOSC. The LOSC rate was 4.5?% (77 of 1729). The LOSC rates were significantly different before and after January 2002 (p?n?=?51) that were hard to repair by endovascular techniques. For the LOSC procedure, 71 cases were elective and 6 were emergent. The perioperative mortality was 5.2?% (4 of 77): 1 was elective (due to septic shock) and 3 were urgent (due to hemorrhagic shock). Conclusion Large type I endoleaks were the main reasons for LOSC. The improvement of devices and operators-experience may decrease the LOSC rate. Urgent LOSC resulted in a high mortality rate, while selective LOSC was relatively safe with significantly lower mortality rate. Early intervention, full preparation, and timely LOSC are important for patients who require LOSC.