title: Secondary interventions following endovascular repair of abdominal aortic aneurysm.
abstract: OBJECTIVE
  To review the outcomes of endovascular abdominal aortic aneurysm repair (EVAR) procedures, to determine the incidence of adverse events, and to assess the need for secondary radiological/surgical interventions.
  
  
  METHODS
  Data from 57 consecutive patients entered in a prospective EVAR database were studied. In addition to database interrogation, case notes and radiology records were reviewed. Frequency and outcome of complications were evaluated after stent-graft placement (mean follow up 20 months).
  
  
  RESULTS
  Overall, 24 adverse events were recorded in 57 patients (42%). The events were endoleaks (14/24), stent migrations (3/24), deployment problems (2/24), limb occlusions (2/24), limb kink (1/24), and femoro-femoral crossover occlusions (2/24). Of all the endovascular patients studied, 23% (13/57) required secondary interventions to maintain aneurysm exclusion. The mean time to secondary intervention in this series was 14 months.
  
  
  CONCLUSIONS
  Over 40% of EVAR procedures were associated with suboptimal clinical outcomes, and more than 20% of the patients required secondary interventions within 5 years of surgery. This high incidence of late secondary intervention is a cause for concern and emphasizes the need for lifelong follow-up.
authors.affiliation: Peninsula Medical School and Vascular Surgery Unit, Royal Cornwall Hospital, Truro, Cornwall, UK.
authors.forename: Krishnan
authors.initials: K
authors.lastname: Subramanian
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Woodburn
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Travis
authors.forename: John
authors.initials: J
authors.lastname: Hancock
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000706:statistics & numerical data; D012086:Reoperation / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed; D014421:Turkey / Q000453:epidemiology; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*