Clinical outcome and technical considerations of late removal of abdominal aortic endografts: 8-year single-center experience.
During an 8-year period, 355 patients underwent endovascular repair of mainly true (97%) infrarenal aneurysms. After a mean follow-up of 48 months, 11 (3.1%) patients required conversion to open repair and 10 were eligible for open surgical intervention. Via a midline incision, explantation of the endograft was performed by using an infrarenal aortotomy. Explantation was done for rupture in four patients (40%), with a marked difference in mortality rates between acute (50%) and elective (0%) explantations. The main reason for explantation was proximal type I endoleak caused by (1) malposition of the device, (2) proximal migration of the endograft, and (3) dislodgment of a tube endograft that followed former central reconstruction. Proximal migration is most worrisome and demands preventive endovascular reintervention. The mortality and morbidity rates of elective explantation are acceptable. When delayed conversion is indicated, priority has to be given to operate on these patients.
de Vries
Jean-Paul P M
JP
Department of Vascular Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands. jppmdevries@planet.nl
van Herwaarden
Joost A
JA
Overtoom
Tim Th
TT
Vos
Jan Albert
JA
Moll
Frans L
FL
van de Pavoordt
Eric D W M
ED
D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000601:surgery; D001012:Aorta, Abdominal / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D020878:Device Removal / Q000379:methods*; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies