BACKGROUND: The aim of this study was to analyze open conversion (OC) after failed endovascular aortic repair (EVAR) and to identify predictors of postoperative mortality. METHODS: It is a single-center, retrospective, observational cohort study of the patients treated between January 1, 1997, and April 30, 2021. Post-hoc analysis recruited only patients who underwent OC with full endograft (EG) explantation because of failed EVAR. Specifically for this study, primary endpoint of interest was early (<30 days) mortality. RESULTS: Twenty-seven patients 27 out of 1051 (2.6%) underwent OC were identified. There were 24 (88.9%) males and 3 females: median age at the time of OCwas 72 years (IQR: 67-79). Open conversion was performed after a median interval of 11 months (IQR: 0-62) from initial EVAR. Eleven (40.7%) patients were operated on urgently (rupture, N.=8). Overall, 30-day mortality rate was 25.9% (N.=7). Binary logistic regression analysis confirmed that rupture at admission was predictive of 30-day mortality (OR=14, 95% CI: 1.8-109.9, P=0.011). The mean follow-up of survivors was 38 months (range: 1-151): overall estimated survival rate was 79±0.8% at 12 months (95% CI: 59.3-89.4), 70±0.9% at 36 months (95% CI: 51.5-84.2), and 63±1% at 60 months (95% CI: 41.3-80). CONCLUSIONS: In our experience, a non-negligible rate of patients requiring OCafter failed EVARpresented with rupture which was the only predictor of early mortality.

Results of open conversion with full endograft explantation after failed EVAR

Muscato P.;Franchin M.;Velo S.;Tozzi M.;Piffaretti G.
Ultimo
Writing – Original Draft Preparation
2022

Abstract

BACKGROUND: The aim of this study was to analyze open conversion (OC) after failed endovascular aortic repair (EVAR) and to identify predictors of postoperative mortality. METHODS: It is a single-center, retrospective, observational cohort study of the patients treated between January 1, 1997, and April 30, 2021. Post-hoc analysis recruited only patients who underwent OC with full endograft (EG) explantation because of failed EVAR. Specifically for this study, primary endpoint of interest was early (<30 days) mortality. RESULTS: Twenty-seven patients 27 out of 1051 (2.6%) underwent OC were identified. There were 24 (88.9%) males and 3 females: median age at the time of OCwas 72 years (IQR: 67-79). Open conversion was performed after a median interval of 11 months (IQR: 0-62) from initial EVAR. Eleven (40.7%) patients were operated on urgently (rupture, N.=8). Overall, 30-day mortality rate was 25.9% (N.=7). Binary logistic regression analysis confirmed that rupture at admission was predictive of 30-day mortality (OR=14, 95% CI: 1.8-109.9, P=0.011). The mean follow-up of survivors was 38 months (range: 1-151): overall estimated survival rate was 79±0.8% at 12 months (95% CI: 59.3-89.4), 70±0.9% at 36 months (95% CI: 51.5-84.2), and 63±1% at 60 months (95% CI: 41.3-80). CONCLUSIONS: In our experience, a non-negligible rate of patients requiring OCafter failed EVARpresented with rupture which was the only predictor of early mortality.
Aneurysm; Conversion to open surgery; Endovascular procedures
Muscato, P.; Franchin, M.; Velo, S.; Cavi, R.; Guzzetti, L.; Tozzi, M.; Piffaretti, G.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/2140217
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