Open Surgical Conversion After Failed Endovascular Aneurysm Sealing.

IF 2.6 Q2 PERIPHERAL VASCULAR DISEASE

Vascular Health and Risk Management Pub Date : 2025-06-13 eCollection Date: 2025-01-01 DOI:10.2147/VHRM.S513365

Sven R Mathisen, Simen Tveten Berge

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引用次数: 0

Abstract

Objective: The aim of this study was to investigate the early and late outcomes of Open Surgical Conversion (OSC) following the failure of Endovascular Aneurysm Sealing (EVAS) endografts, regarding surgical technique, morbidity and mortality.

Method and material: A single center retrospective observational cohort of 46 patients undergoing OSC after EVAS failure. Primary endpoints were primary technical procedural success and 30-day mortality. Secondary endpoints were complications and primary prosthesis patency.

Results: Primary technical procedural success was 97.8% (45/46). Elective 30-day mortality for OSC was 10.9% (5/42) and 75% (3/4) for acute OSC procedures. Median survival after OSC was 4.2 years (IQR 1.0, 4.9 years). Four peri-operative and 17 post-operative complications were registered. Major complications included bleeding, myocardial infraction, acute renal failure and splenectomy. Primary prosthesis patency was 82.6% (38/46) at 30-days. At median follow-up of 4.7 years (IQR 3.9, 5.3 years) 69.6% (32/46) of the patients are still alive with patent vascular prostheses.

Conclusion: Open surgical conversion achieved acceptable technical success rate for failed EVAS, with better outcomes in elective versus emergency procedures. Enhanced surveillance with timely interventions before rupture and careful patient selection through multidisciplinary evaluation are essential for optimizing surgical outcomes.

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血管内动脉瘤封闭失败后的开放性手术转换。

目的：本研究的目的是探讨血管内动脉瘤密封（EVAS）内移植物失败后开放手术转换（OSC）的早期和晚期结局，包括手术技术、发病率和死亡率。方法和材料：对46例EVAS失效后行OSC的患者进行单中心回顾性观察队列研究。主要终点为主要技术手术成功和30天死亡率。次要终点为并发症和原发性假体通畅。结果：初级技术手术成功率97.8%（45/46）。急性OSC手术的选择性30天死亡率为10.9%（5/42）和75%（3/4）。OSC后的中位生存期为4.2年（IQR 1.0, 4.9年）。4例围手术期并发症，17例术后并发症。主要并发症包括出血、心肌梗死、急性肾功能衰竭和脾切除术。30天时，一期假体通畅率为82.6%（38/46）。中位随访4.7年（IQR为3.9年，5.3年），69.6%（32/46）的患者在血管假体未闭的情况下仍然存活。结论：对于失败的EVAS，开放手术转换获得了可接受的技术成功率，选择手术优于急诊手术。通过多学科评估，在破裂前及时干预和仔细选择患者，加强监测对优化手术结果至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vascular Health and Risk Management PERIPHERAL VASCULAR DISEASE-

CiteScore

4.20

自引率

3.40%

发文量

109

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed journal of therapeutics and risk management, focusing on concise rapid reporting of clinical studies on the processes involved in the maintenance of vascular health; the monitoring, prevention, and treatment of vascular disease and its sequelae; and the involvement of metabolic disorders, particularly diabetes. In addition, the journal will also seek to define drug usage in terms of ultimate uptake and acceptance by the patient and healthcare professional.