Secondary procedures after endovascular aortic aneurysm repair

Journal of Vascular Surgery
Michael S ConnerSamuel R Money

Abstract

The purpose of this study was to evaluate the incidence, distribution, and indications of secondary procedures after endovascular aortic aneurysm repair (EAR). At a single institution, 179 patients underwent EAR with four different endografts (AneuRx, n = 117; Zenith, n = 49; Ancure, n = 12; and Talent, n = 1). The vascular section database was queried for patients who needed secondary procedures after the original EAR. The mean time from EAR to the termination of the study was 27.0 +/- 16.7 months. Type I or III endoleaks were treated aggressively. Type II endoleaks were treated only in the presence of aneurysm expansion. Thirty-five (35/179; 19.6%) secondary procedures were performed in 32 patients. Indications for secondary procedures included 14 limb occlusions or stenoses (40.0%), 13 endoleaks (37.1%), six endograft migrations (17.1%), one delayed aneurysm rupture (2.8%), and one device malfunction (2.8%). Seven of the 10 early (<90 days) limb failures (70%) occurred within the first 60 patients. At that time, a protocol with aggressive external iliac artery evaluation was adopted. In the next 125 patients, the rate of early limb occlusion or stenosis was 2.4% (P =.025, with Fisher exact test). Distribution of secondary pr...Continue Reading

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