title: Secondary modification into aortouniiliac configuration to salvage failed endovascular aneurysm repair is safe and effective but not associated with higher intervention rates during long-term follow-up.
abstract: BACKGROUND
  Reports of secondary modifications into aortouniiliac configuration to salvage-failed endovascular aneurysm repair (EVAR) are limited. We evaluated long-term results after these procedures and compared them with those after primary aortouniiliac endografting (AUE).
  
  
  METHODS
  A retrospective review of all EVAR performed from March 1995 until July 2011 was conducted. Patients were included when primary AUE (group I) or modification into aortouniiliac configuration (group II) was done.
  
  
  RESULTS
  Data analysis obtained 27 group I and 23 group II patients. Salvage of failed EVAR could be achieved in 96% of group II patients, and mortality was zero. Frequency of adverse events and amount of interventions to maintain aneurysm exclusion were not increased after secondary AUE. Kaplan-Meier estimates for long-term survival between groups were comparable (P = .36).
  
  
  CONCLUSIONS
  Secondary AUE allows correction of graft-related endoleaks potentially leading to late aneurysm rupture. Complications and adverse events throughout long-term follow-up were not necessarily increased when compared with primary AUE.
authors.affiliation: Department of Vascular Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria, Europe. Electronic address: alexander.prusa@meduniwien.ac.at.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Prusa
authors.affiliation: Department of Cardiovascular and Interventional Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria, Europe.
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Wibmer
authors.affiliation: Department of Cardiovascular and Interventional Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria, Europe.
authors.forename: Maria
authors.initials: M
authors.lastname: Schoder
authors.affiliation: Department of Cardiovascular and Interventional Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria, Europe.
authors.forename: Martin
authors.initials: M
authors.lastname: Funovics
authors.affiliation: Department of Cardiovascular and Interventional Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria, Europe.
authors.forename: Johannes
authors.initials: J
authors.lastname: Lammer
authors.affiliation: Department of Vascular Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria, Europe.
authors.forename: Peter
authors.initials: P
authors.lastname: Polterauer
authors.affiliation: Department of Vascular Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria, Europe.
authors.forename: Georg
authors.initials: G
authors.lastname: Kretschmer
authors.affiliation: Department of Vascular Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria, Europe.
authors.forename: Harald
authors.initials: H
authors.lastname: Teufelsbauer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057867:Endoleak / Q000401:mortality / Q000601:surgery*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D012086:Reoperation; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome
keywords: Abdominal aortic aneurysm; Aortouniiliac endografting; Endoleak; Endovascular aneurysm repair; Follow-up