Open surgical conversion and management of patients with ruptured abdominal aortic aneurysm after previous endovascular aneurysm repair
| Autor: | Marković Miroslav, Zlatanović Petar, Dimić Andreja, Končar Igor, Sladojević Miloš, Tomić Ivan, Mutavdžić Perica, Davidović Lazar |
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| Jazyk: | English<br />Serbian |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Srpski Arhiv za Celokupno Lekarstvo, Vol 150, Iss 7-8, Pp 428-432 (2022) |
| Druh dokumentu: | article |
| ISSN: | 0370-8179 2406-0895 |
| DOI: | 10.2298/SARH211229067M |
| Popis: | Introduction/Objective. The objective was to present the results and technical considerations from high-volume center when performing late open surgical conversion (LOSC) after endovascular aneurysm repair (EVAR) in ruptured abdominal aortic aneurysm (RAAA) patients. Methods. This was a single center retrospective study. LOSC was performed whenever eventual endovascular reintervention failed, was not feasible due to hostile anatomy and unavailability of specific endograft materials, or when patient was hemodynamically unstable necessitating emergent surgery. Results. All previously implanted EVARs had bimodular configuration with suprarenal fixation. Total endograft explantation was performed in 40% of patients. Hospital mortality was 20%. Both patients who died had total endograft explantation with supraceliac clamp lasting more than 30 minutes. 30-day mortality was 30%, with one more patient who died from pulmonary embolism after hospital discharge and two hospital deaths were due to myocardial infarction. Conclusion. LOSC due to RAAA after previous EVAR carries greater mortality for the patient, suggesting multifactorial impacts on the outcome. The appropriate choice of surgical method and technical success are of ultimate importance, with total graft explantation having negative impact on patient’s survival. |
| Databáze: | Directory of Open Access Journals |
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