Late rupture of abdominal aortic aneurysm after endovascular repair

Abstract

This study confirmed that endovascular AAA repair does not prevent rupture in all patients. The data suggest that rupture, when it does occur, may not be accompanied by such major hemodynamic changes and higher mortality rate as with rupture of an untreated AAA. Strict surveillance and follow-up are required, especially in patients with relatively large initial AAA diameter or presence of endoleak and graft migration, to reduce the rate of ruptures after endovascular repair. Complete prevention will remain challenging because rupture may occur without any predisposing abnormalities. With the advent of new-generation devices, continuous larger long-term studies are required to document reduction in rupture rates after endovascular aneurysm repair.

Does a previous aortic endograft confer any protective effect during abdominal aortic aneurysm rupture? Systematic review and meta-analysis of comparative studies

“…After reviewing titles, abstracts and full-text versions of these articles, five studies fulfilled the inclusion criteria and were included in qualitative synthesis. 14–18 Two studies originated from the same institution, and the data from the older study were included in the more recent report which was finally included in the quantitative synthesis which involved four studies. The literature flow chart is presented in Figure 1.…”

Improving Patient Compliance With Post-EVAR Surveillance May Prevent Late Rupture

“…11 In the latter 11 years of the study, the mean time to rupture from the index procedure and last follow-up was 4.9 years (range 1.7-13.2 years) and 118 days (range 2.9-297 days), respectively. 11 Alarmingly, Greiner et al 12 retrospective single-center analysis of ruptured AAAs from 2011 to 2013 reported that of the ruptured AAAs presenting to an institution, 20% (6 out of 30) were late ruptures after EVAR.…”

“…7 A lower incidence of 0.9% (95% CI: 0.77-1.05) with a mean time to rupture of 37 months was reported in a recent metaanalysis of case series and cohort studies. 7 The studies performed by May et al 10 and subsequently by Rajendran et al 11 which compared the outcomes of late rupture after EVAR to rupture after no intervention found 3.1% (40 out of 1288) of patients during a 22-year period had a late rupture. 11 In the latter 11 years of the study, the mean time to rupture from the index procedure and last follow-up was 4.9 years (range 1.7-13.2 years) and 118 days (range 2.9-297 days), respectively.…”

“…7 The studies performed by May et al 10 and subsequently by Rajendran et al 11 which compared the outcomes of late rupture after EVAR to rupture after no intervention found 3.1% (40 out of 1288) of patients during a 22-year period had a late rupture. 11 In the latter 11 years of the study, the mean time to rupture from the index procedure and last follow-up was 4.9 years (range 1.7-13.2 years) and 118 days (range 2.9-297 days), respectively. 11 Alarmingly, Greiner et al 12 retrospective single-center analysis of ruptured AAAs from 2011 to 2013 reported that of the ruptured AAAs presenting to an institution, 20% (6 out of 30) were late ruptures after EVAR.…”

Survival following abdominal aortic aneurysm repair in North Queensland is not associated with remoteness of place of residence

“…Late complications, such as endoleak, anastomotic aneurysm, graft migration, graft occlusion and new aortic aneurysm formation, have been reported following open or endovascular AAA repair [2,25,26]. Current guidelines recommend repeat aortic imaging and follow-up after AAA surgery, particularly endovascular repair [7,12].…”