Back to Search
Start Over
Secondary Endovascular Repair of Recurring Lesions and Perioperative Complications after Open Aortic Repair: The Complementary Role of Different Technical Solutions.
- Source :
-
Annals of vascular surgery [Ann Vasc Surg] 2020 Feb; Vol. 63, pp. 99-107. Date of Electronic Publication: 2019 Aug 23. - Publication Year :
- 2020
-
Abstract
- Background: The aim of our article was to describe the complementary role of different technical solutions for secondary endovascular repair of recurring lesions and perioperative complications after open aortic repair (OAR).<br />Methods: We describe our clinical experience of secondary endovascular repair after OAR. We included in the analysis all consecutive patients who presented recurring lesions and perioperative complications after OAR and underwent secondary endovascular repair between January 1, 2015 and June 31, 2018. Both elective and nonelective cases were captured. Early end points were technical success, 30-day mortality, 30-day major adverse events, and 30-day vascular access complications. Late end points were survival and freedom from secondary interventions.<br />Results: Three different techniques were used in 6 patients: 2 cases of fenestrated-branched endovascular aortic repair (F-BEVAR), 2 cases of parallel-graft EVAR (pg-EVAR), and 2 cases of off-label use of standard devices. Technical success was 100%. One patient died within 30 days from acute pulmonary embolism. One patient developed acute kidney injury not requiring renal replacement therapy, whereas the remaining 4 patients were free from 30-day major adverse events. The cumulative rate of 30-day vascular access complications was 0%. All the 5 patients who survived the index hospitalization had ≥12 months of clinical and imaging follow-up. At the longest individual follow-up, they all were alive and free from secondary interventions. Computed tomography angiography showed in all cases sustained clinical success.<br />Conclusions: Secondary endovascular repair of recurring lesions and perioperative complications after OAR is safe and feasible and offers a minimally invasive effective treatment option when a redo surgical operation would be associated with a considerable risk to the patient. Different solutions are available (including F-BEVAR, pg-EVAR, and off-label use of standard devices) and are complementary rather than competitive. Careful preoperative assessment and familiarity with advanced techniques are essential to achieve satisfactory outcomes.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Aorta diagnostic imaging
Aortic Diseases diagnostic imaging
Aortic Diseases mortality
Blood Vessel Prosthesis
Humans
Male
Middle Aged
Postoperative Complications diagnostic imaging
Postoperative Complications etiology
Postoperative Complications mortality
Recurrence
Retrospective Studies
Risk Factors
Stents
Time Factors
Treatment Outcome
Angioplasty, Balloon adverse effects
Angioplasty, Balloon instrumentation
Angioplasty, Balloon mortality
Aorta surgery
Aortic Diseases surgery
Blood Vessel Prosthesis Implantation adverse effects
Blood Vessel Prosthesis Implantation instrumentation
Blood Vessel Prosthesis Implantation mortality
Postoperative Complications therapy
Vascular Surgical Procedures adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1615-5947
- Volume :
- 63
- Database :
- MEDLINE
- Journal :
- Annals of vascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 31449951
- Full Text :
- https://doi.org/10.1016/j.avsg.2019.06.015