Unit:
Speciality Endovascular TechniquesLibrary of the School of Health Sciences
Supervisors info:
Καθηγητής Χρήστος Λιάπης, Επ. Καθηγητής Ιωάννης Κακίσης, Επ. Καθηγητής Χρήστος Κλωνάρης
Original Title:
Open conversion repair after EVAR
Summary:
Purpose: To review the incidence, causes, mortality and surgical techniques of
conversion to open surgery after endovascular aneurysm repair (EVAR) of
abdominal aortic aneurysm (AAA).
Methods: A multiple electronic health database search was performed, including
PubMed, Medline and EMBASE, on all articles published between January of 2002
and December of 2012 that included at least 100 EVAR patients with a median
follow-up >1 year and reported the incidence of early and late open conversion.
The search yielded 16 articles with sufficient data to analyze.
Results: The rates of open conversion vary from 0.9% to 28% in the reviewed
articles. Among a total of 13522 EVAR 485 (3.4%) open conversions were reported
with 203 (1.5%) early conversions, reflecting 42% of the overall open
conversions. The reporting mortality of early open conversions ranged from 0%
to 35% and the estimated average mortality was 12.7%. In addition 282 (2%) late
conversions were reported, representing 58% of total open conversion with an
incidence and mortality rate varying from 0.4% to 22% and 0% to 20%
respectively.
Conclusions: The incidence of secondary interventions after EVAR has decreased
in recent years. Despite this fact reinterventions including open surgical
conversion is still the basic disadvantage of EVAR making life-long follow-up
basic part of the method. The vascular surgeon should be familiar with the
complex open conversion procedures.
Keywords:
Abdominal aortic aneurysm, Endovascular aneurysm repair, Open conversion, Rapture, Endoleak
