Secondary conversion due to failed endovascular abdominal aortic aneurysm repair

Late open conversion and explantation of abdominal aortic stent grafts

“…[8][9][10][11][12]14,16,17 Late surgical conversion with complete endograft removal and aortic reconstruction with a standard tube or bifurcated surgical graft has been associated with a high mortality when compared to elective AAA repair. 4,12,13 An early series reported in 1999 by May and colleagues 6 noted a 17% mortality following open conversion, and other early series noted morality rates ranging from 20% to 43%. 2,4,11,13 More recent series have reported mortality rates between 0% and 22%.…”

“…3,4,[6][7][8] Open conversion is reported in up to 5% of cases after EVAR at experienced centers, and the associated morbidity and mortality rates with secondary conversion can be significantly higher than those encountered with primary open repair. 6,7,[9][10][11][12][13] We report a single university hospital experience with late conversion of previous EVAR to review the current indications and operative strategy for open conversion, as well as to assess patient outcomes following explantation of endografts and subsequent aortic reconstruction.…”

Conversion to Open Surgery After Endovascular Abdominal Aortic Aneurysms Repair

“…The stentgraft configuration and stentgraft system type has a significant impact on the occurrence of late conversion to OS. Poor results of tube stentgrafts have been reported and some technical problems and structural failure especially in so called "first generation stentgrafts" have been mentioned [21][22][25][26][27] . In these cases, prophylactic conversion is recommended in some reports 15 .…”

What is the significance of endoleaks and endotension

“…However, surgical conversion is associated with a high (20%) mortality rate [35,63,64]. Patients who are at especially high risk for open surgery may, on occasion, be observed with careful, ongoing monitoring.…”