Delayed Open Conversion after Endovascular Abdominal Aortic Aneurysm: Device-specific Surgical Approach

摘要: Objectives Despite several advances in endoluminal salvage for failed endovascular abdominal aortic repair (EVAR), our experience an increasing number of cases necessitate delayed open conversion (dOC). Methods EVAR patients requiring (>30 days) were prospectively collected a computerized database including demographics, details aortoiliac anatomy, procedural and clinical success, postoperative complications. Results Between 2005 2011, 54 treated stent-graft explantation. Indications included 34 type I III endoleaks, 13 II endoleaks with aneurysm growth, 4 material failures, 3 infections. All fit-for-surgery I/III endoleak underwent directly dOC. Different surgical approaches used depending on the stent-graft. Overall 30-day mortality was 1.9%. morbidity 31% mainly due to acute renal failure (13 cases). Mean hospitalization 6 days (range, 5–27 days). survival at mean follow-up 19 months 78%. Conclusions In recent years, use has increased dramatically, young regardless their fitness repair. dOC after seems be lifesaving procedure satisfactory initial mid-term results.