Open Thoracoabdominal Aortic Procedures following Endovascular Intervention

Abstract

Open conversion of thoracoabdominal aortic (TAA) disease after failed attempts of endovascular treatment is increasingly required. The main causes are endoleak, endograft failure, infection, disease progression, or persistent false lumen perfusion in dissected aortas. Mortality and morbidity rates are high, higher than after standard TAA open repair. Therefore, this surgery should be performed only in dedicated centers by experienced teams. Specific perioperative organ protection protocols, as well as surgical techniques, are crucial to guarantee acceptable results.

Outcomes following Management of Complex Thoracoabdominal Aneurysm by an Open Approach

“…The two groups were similar for the majority of preoperative characteristics, except for history of smoking and previous aortic surgery (Table 1). In Group 2, a higher number of procedures performed after previous open or endovascular repair was noted, and this may be related to the continuously increasing number of endovascular procedures performed in both the thoracic and the abdominal aortic segments [29,30]. Notably, the progressive employment of different adjuncts in Group 2, and the concomitant introduction of them, makes the evaluation of the effective role of any single adjunct hard to define.…”