title: Aortomonoiliac endografting after failed endovascular aneurysm repair: indications and long-term results.
abstract: OBJECTIVE
  To present long-term results of endoleak/endograft migration treatment by aortomonoiliac (AMI) endografting after failed endovascular aneurysm repair (EVAR) of infrarenal abdominal aortic aneurysms.
  
  
  METHODS
  Post hoc analysis of a prospectively gathered database at a tertiary care university hospital.
  
  
  METHODS
  From March 1995 to November 2010, 23 patients were identified who underwent modification into AMI configuration after failed elective EVAR. Major causes for modification were type I (with/without endograft migration) or type III endoleaks with aneurysm expansion. An average increase in aneurysm size of 1.6 cm (range: -1.5 to 10.5 cm) since initial aneurysm treatment was observed. Interventional outcomes and long-term results were recorded for analysis.
  
  
  RESULTS
  Technical success rate of AMI endografting was 95.65% (n = 22). All except two endoleaks could be successfully sealed with this manoeuvre (94.44%). Median time to modification was 5.3 years (interquartile range Q1-Q3: 1.3-9.3 years). No intra-operative conversion to open surgery was necessary and mortality was 0%. Median follow-up was 44 months (interquartile range Q1-Q3: 17-69 months).
  
  
  CONCLUSIONS
  Treatment of graft-related endoleaks/endograft migration by AMI endografting after failed EVAR represents a safe and feasible procedure. This approach broadens the minimal invasive opportunities of aneurysm treatment, and open surgical conversion may be avoided except in selected patients.
authors.affiliation: Department of Vascular Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: A M
authors.initials: AM
authors.lastname: Prusa
authors.forename: A G
authors.initials: AG
authors.lastname: Wibmer
authors.forename: M
authors.initials: M
authors.lastname: Schoder
authors.forename: M
authors.initials: M
authors.lastname: Funovics
authors.forename: J
authors.initials: J
authors.lastname: Lammer
authors.forename: P
authors.initials: P
authors.lastname: Polterauer
authors.forename: G
authors.initials: G
authors.lastname: Kretschmer
authors.forename: H
authors.initials: H
authors.lastname: Teufelsbauer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D001012:Aorta, Abdominal / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D001317:Austria / Q000453:epidemiology; D001807:Blood Vessel Prosthesis; D057867:Endoleak / Q000401:mortality / Q000601:surgery*; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008297:Male; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome