title: Rupture after endovascular abdominal aortic aneurysm repair: a multicenter study.
abstract: A total of 22 patients with ruptured abdominal aortic aneurysms (rAAAs) after previous endovascular aortic repair (EVAR; rAAAevar) were presented to 7 referral hospitals in Greece, between January 2006 and April 2012. Type Ia endoleak and endograft migration were identified in 72.7% and 50%, respectively. Compliance to follow-up protocol prior to rupture was 31.8%. In-hospital mortality was 36.4% (9.1% for those treated with secondary EVAR and 63.6% for those treated with open surgical repair, P = .02). An increase in the proportion of patients with rAAAevar among the total number of patients with rAAAs from 1.3% in 2007 to 18.2% in 2012 (P for trend = .04) was recorded, corresponding to an annual increase of 2.8% (b = 2.84, P = .04). Rupture after EVAR seemed to be a clinical entity encountered with increasing frequency over the past years. Type I endoleak and endograft migration were most frequently observed, whereas compliance to follow-up was low.
authors.affiliation: Department of Vascular Surgery, University General Hospital "Attikon", Athens, Greece kostas.antonopoulos@gmail.com.
authors.forename: Constantine N
authors.initials: CN
authors.lastname: Antonopoulos
authors.affiliation: Department of Vascular Surgery, University General Hospital "Attikon", Athens, Greece.
authors.forename: John D
authors.initials: JD
authors.lastname: Kakisis
authors.affiliation: Department of Vascular Surgery, University General Hospital "Attikon", Athens, Greece.
authors.forename: Triantafillos G
authors.initials: TG
authors.lastname: Giannakopoulos
authors.affiliation: Department of Vascular Surgery, General Hospital "Korgialenio-Benakio National Red Cross", Athens, Greece.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Andrikopoulos
authors.affiliation: Department of Vascular Surgery, General Hospital "Konstantopoulio-Agia Olga", Athens, Greece.
authors.forename: Pavlos
authors.initials: P
authors.lastname: Antoniadis
authors.affiliation: Department of Vascular Surgery, General Hospital "Korgialenio-Benakio National Red Cross", Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Bessias
authors.affiliation: Department of Vascular Surgery, General Hospital "Konstantopoulio-Agia Olga", Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Dervisis
authors.affiliation: Department of Vascular Surgery, General Hospital "Laikon", Athens, Greece.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Georgopoulos
authors.affiliation: Department of Vascular Surgery, University Hospital of Larissa, Larissa, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Giannoukas
authors.affiliation: Department of Vascular Surgery, General Hospital "Sismanoglio", Athens, Greece.
authors.forename: Elias
authors.initials: E
authors.lastname: Kaperonis
authors.affiliation: Department of Vascular Surgery, General Hospital of Thessaloniki "Papageorgiou", Thessaloniki, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kiskinis
authors.affiliation: Department of Vascular Surgery, General Hospital "Laikon", Athens, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Klonaris
authors.affiliation: 3rd Surgical Department, University General Hospital "Attikon", Athens, Greece.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Machairas
authors.affiliation: Department of Vascular Surgery, General Hospital "Sismanoglio", Athens, Greece.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Papavassiliou
authors.affiliation: Department of Vascular Surgery, University Hospital of Larissa, Larissa, Greece.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Saleptsis
authors.affiliation: Department of Vascular Surgery, General Hospital of Thessaloniki "Papageorgiou", Thessaloniki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Saratzis
authors.affiliation: 3rd Surgical Department, University General Hospital "Attikon", Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Seretis
authors.affiliation: Department of Vascular Surgery, General Hospital "Konstantopoulio-Agia Olga", Athens, Greece.
authors.forename: Charalambos
authors.initials: C
authors.lastname: Tampakis
authors.affiliation: Department of Vascular Surgery, University General Hospital "Attikon", Athens, Greece.
authors.forename: Christos D
authors.initials: CD
authors.lastname: Liapis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D016208:Databases, Factual; D057867:Endoleak / Q000209:etiology; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology; D006115:Greece; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: EVAR; abdominal aortic aneurysm; endovascular aortic repair; mortality; rupture