title: Secondary interventions after endovascular abdominal aortic aneurysm repair.
abstract: BACKGROUND
  One adverse outcome of endovascular abdominal aortic aneurysm (AAA) repair (EVAR) is a significantly increased incidence of secondary interventions (SIs) required compared with traditional open aortic repair. We present a consecutive series of EVARs using a single endograft to identify the incidence and types of SIs performed.
  
  
  METHODS
  From February 1, 2000, to January 31, 2005, we repaired 136 AAAs with the Zenith (Cook, Bloomington, Indiana) endograft. All patients met the same strict anatomic inclusion and exclusion criteria. Follow-up lasted from 1.5 to 61 months (median 36). The indications for SI group A were procedural and technical errors, for group B were aortic morphology, and for group C were device failures.
  
  
  RESULTS
  Twenty-one SIs were required in 17 of 136 patients (12.5%). Three patients required multiple interventions. Nine patients were in group A, four were in group B, and six were in group C. All but 4 patients required SIs for late (>30 days) complications.
  
  
  CONCLUSIONS
  Although it is a viable alternative to open aortic repair, EVAR is associated with a significantly higher rate of SIs. To maintain the efficacy of EVAR, patients must be followed-up in a vigilant graft surveillance protocol for life.
authors.affiliation: Peripheral Vascular Surgery Section, Richard L. Roudebush Veteran's Affairs Medical Center, 1481 West 10th St., Indianapolis, IN 46202, USA. sglalka@iupui.edu
authors.forename: Stephen
authors.initials: S
authors.lastname: Lalka
authors.forename: Michael
authors.initials: M
authors.lastname: Dalsing
authors.forename: Dolores
authors.initials: D
authors.lastname: Cikrit
authors.forename: Alan
authors.initials: A
authors.lastname: Sawchuk
authors.forename: Shoaib
authors.initials: S
authors.lastname: Shafique
authors.forename: Ryan
authors.initials: R
authors.lastname: Nachreiner
authors.forename: Keshav
authors.initials: K
authors.lastname: Pandurangi
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler