T Kaartama, D Esposito, Mg Pascucci, S Zacá, D Angiletta, E Civilini, M Venermo, G Pratesi, Ps Aho
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引用次数: 0
Abstract
Objective: Open surgical conversion after failed EVAR has become more common. Our aim was to compare the short- and long-term results of late open conversions for non-infectious indications with partial or total stent graft removal.
Methods: Our study is a retrospective, multicentre observational study of late open conversions performed in five hospitals between January 1997 and June 2024. Patients who underwent a partial or total removal of a stent graft more than 30 days after EVAR for non-infectious indications were included in the analysis and divided into two groups: partial (PC) and total conversion (TC). The primary outcomes were 30-day mortality, 5-year survival and freedom from late complications. The secondary outcomes were peri-operative cardiovascular complications, the length of hospital stay and 5-year freedom from reinterventions and from aneurysm-related death.
Results: The analysis included 97 patients: 57 (58.8%) in the PC group, and 40 (41.2%) in the TC group. The 30-day mortality in the PC group was lower compared to the TC group (14.3% vs 24.3%, OR = 0.52, p = .220), although the difference did not reach statistical significance. The estimated 5-year overall survival was similar in the PC and TC groups (58.8% vs 59.8%, p = .726). The patients in the PC group had no infections or thrombosis and a similar freedom from late complications compared to the TC group (81.2% vs 84%, p = .788). A subgroup analysis comparing the preoperative CTA scans and intra-operative observations revealed an occult endoleak in 22 patients (22.7%), and in the 12 patients (12.4%) who underwent surgery for a suspected endoleak, none were identified during the procedure.
Conclusions: Partial conversion appears to be non-inferior to total conversion and possibly even safer, with a trend towards lower mortality in the short term. No differences in mortality or complications were found between the groups during long-term follow-up .
期刊介绍：
Journal of Vascular Surgery ® aims to be the premier international journal of medical, endovascular and surgical care of vascular diseases. It is dedicated to the science and art of vascular surgery and aims to improve the management of patients with vascular diseases by publishing relevant papers that report important medical advances, test new hypotheses, and address current controversies. To acheive this goal, the Journal will publish original clinical and laboratory studies, and reports and papers that comment on the social, economic, ethical, legal, and political factors, which relate to these aims. As the official publication of The Society for Vascular Surgery, the Journal will publish, after peer review, selected papers presented at the annual meeting of this organization and affiliated vascular societies, as well as original articles from members and non-members.
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