Abdominal Aortic Aneurysm Research Today is a free monthly online journal that collates and summarizes the latest research about Abdominal Aortic Aneurysm, including details on aaa (abdominal aortic aneurism), cardiac disease, treatment, symptoms, surgery. | ||||||||
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Surgical conversion of abdominal aortic stent-grafts--outcome and technical considerations.Tiesenhausen K, Hessinger M, Konstantiniuk P, Tomka M, Baumann A, Thalhammer M, Portugaller H Department of Vascular Surgery, University Hospital Graz, Graz, Austria. kurt.tiesenhausen@meduni-graz.at 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. Published 12 December 2005 in Eur J Vasc Endovasc Surg, 31(1): 36-41.
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