Reintervention after EVAR and Open Surgical Repair of AAA

Abstract

Reintervention was more common with EVAR and occurred later. Early reintervention after OSR is associated with significant mortality. If early reintervention in OSR patients can be avoided, there is no early survival advantage to EVAR. Current endografts require fewer reinterventions than earlier devices.

Early reintervention after open and endovascular abdominal aortic aneurysm repair is associated with high mortality

“…9 Prior studies found a declining rate of late reinterventions following EVAR with newer generation endografts. 7, 21, 22 While we studied early interventions, we also noticed a very low rate of vascular-related reinterventions among the EVAR patients (< 2%), which may reflect better outcomes with these more modern endografts between 2012 and 2014. Indeed, fully one in five of the reinterventions from the EVAR-1 trial (corresponding to 2% of all EVARs performed), underwent conversion to open repair within the first 30-days, while only three patients (< 0.1%) in our modern series underwent conversion to open repair.…”

Comparison of outcomes after endovascular and open repair of abdominal aortic aneurysms in low-risk patients

“…Traditionally, patients having EVAR have been shown to have a higher rate of reintervention than those undergoing OAR. The analysis of reinterventions in the present study is limited because the follow‐up for reintervention was restricted to 1 year; it is quite possible that many reinterventions occur during longer‐term follow‐up. Although the rates of reintervention are similar, it is not possible to determine the scale of reintervention for either technique.…”

Late‐onset type I endoleak characterized by contrast enhanced ultrasound after endovascular repair of aortic aneurysm

“…As such, regular life‐long repeat imaging will be necessary to allow detection and correction of these complications. Reintervention rate was also found to be higher in patient with EVAR (9%) than in those treated with open surgical repair (1.7%), with endoleaks responsible for 66% of EVAR reinterventions …”