OBJECTIVE: The purpose of this study was to evaluate the outcome of patients with stented abdominal aortic aneurysms who had to undergo open aneurysm repair with partial or total stent-graft removal. METHODS: Between October 1996 and December 2003, 117 patients with abdominal aortic aneurysms underwent endovascular repair. When open surgery was necessary during the initial and same anaesthesia as stent-graft implantation, it was defined as immediate conversion. When conversion was performed during a second anaesthesia, we defined it as late (acute or elective) conversion. RESULTS: A total of 33 patients underwent conversion to open surgery. In 7 (6%) patients, immediate conversion was necessary due to stent-graft misplacement and obstruction of the renal arteries (n=4), type Ia endoleaks (n=2) and stent-graft dislocation into the aneurysm sac (n=1). During a mean follow-up period of 39.6 months (min 0.03 months, max 80.4 months), 26 (23.6%) of the remaining 110 patients underwent late conversion to open surgery for endoleak (n=12), rupture (n=6), thrombosis (n=4), graft fatigue (n=2), aorto-duodenal fistula (n=1), and recurring peripheral embolisms (n=1). The mortality of acute conversion was 38% (5 of 13). Elective conversion did not lead to any mortality. CONCLUSION: Acute conversion of stented abdominal aortic aneurysms is associated with a high mortality. Elective stent-graft explantation with open aortic reconstruction is a safe but complex procedure.
OBJECTIVE: The purpose of this study was to evaluate the outcome of patients with stented abdominal aortic aneurysms who had to undergo open aneurysm repair with partial or total stent-graft removal. METHODS: Between October 1996 and December 2003, 117 patients with abdominal aortic aneurysms underwent endovascular repair. When open surgery was necessary during the initial and same anaesthesia as stent-graft implantation, it was defined as immediate conversion. When conversion was performed during a second anaesthesia, we defined it as late (acute or elective) conversion. RESULTS: A total of 33 patients underwent conversion to open surgery. In 7 (6%) patients, immediate conversion was necessary due to stent-graft misplacement and obstruction of the renal arteries (n=4), type Ia endoleaks (n=2) and stent-graft dislocation into the aneurysm sac (n=1). During a mean follow-up period of 39.6 months (min 0.03 months, max 80.4 months), 26 (23.6%) of the remaining 110 patients underwent late conversion to open surgery for endoleak (n=12), rupture (n=6), thrombosis (n=4), graft fatigue (n=2), aorto-duodenal fistula (n=1), and recurring peripheral embolisms (n=1). The mortality of acute conversion was 38% (5 of 13). Elective conversion did not lead to any mortality. CONCLUSION: Acute conversion of stented abdominal aortic aneurysms is associated with a high mortality. Elective stent-graft explantation with open aortic reconstruction is a safe but complex procedure.
Authors: Gian Franco Veraldi; Leonardo Gottin; Bruno Genco; Andrea Bricolo; Sebastiano Tasselli; Giuseppe Faggian; Alessandro Mazzucco Journal: Gen Thorac Cardiovasc Surg Date: 2012-05-08
Authors: Klaas H J Ultee; Peter A Soden; Sara L Zettervall; Jeremy Darling; Hence J M Verhagen; Marc L Schermerhorn Journal: J Vasc Surg Date: 2016-07 Impact factor: 4.268