Objectives: The frequency of late removal of endovascular abdominal aortic repair (EVAR) parallels the rise of endovascular aortic repair. Evaluation of outcomes for EVAR explants may identify risks for complications and alter clinical management.
Methods: A patient database was used to identify EVAR patients requiring explant >1 month after implant. A retrospective analysis was conducted of the type of graft, duration of implant, reason for removal, operative technique, death, and length of stay.
Results: During 1999 through 2007, 1606 EVARs were performed, and 25 patients required explantation, with an additional 16 referred from other institutions (N = 41). The average age was 73 years (range, 50-87 years); 90% were men. Grafts were excised after a median of 33.3 months (range, 3-93 months). Explanted grafts included 16 AneuRx (40%), 7 Ancure (17%), 6 Excluder (15%), 4 Zenith (10%), 4 Talent (10%), 1 Cook Aortomonoiliac rupture graft, 1 Endologix, 1 Quantum LP, and 1 homemade tube graft. Overall hospital mortality was 19% and occurred after conversion for rupture in 4, and in infected graft, aortoenteric fistula, repair of new aneurysm of the visceral segment, and claudication due to graft stenosis in one patient each. Elective EVAR-related mortality was 3.3%. Mortality was higher in patients with rupture compared with nonrupture (4 of 6 vs 3 of 35, P
Conclusion: Elective EVAR conversion, although technically challenging may be done with mortality similar to primary open repair. Mortality for conversion for infected grafts and ruptured aneurysms remains high. EVAR is associated with continued risk of conversion, and surveillance may identify late complications that require removal, justifying lifelong monitoring. Aggressive management of late complications and elective conversion may minimize the mortality associated with this procedure.
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http://dx.doi.org/10.1016/j.jvs.2008.10.020 | DOI Listing |
Drug Deliv Transl Res
January 2025
Center for Coronary Heart Disease, Department of Cardiology, National Center for Cardiovascular Diseases of China, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Rd, Beijing, 100037, China.
Atherosclerosis is one of the leading causes of ischemic cardiovascular disease worldwide. Recent studies indicated that vascular smooth muscle cells (VSMCs) play an indispensable role in the progression of atherosclerosis. Exosomes derived from mesenchymal stem cells (MSCs) have demonstrated promising clinical applications in the treatment of atherosclerosis.
View Article and Find Full Text PDFAnn Med
December 2025
Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, PR China.
Background: This study aimed to investigate the demographics and to evaluate long-term outcomes of acute type A aortic dissection (ATAAD) in surgically treated patients ≤40 years in China.
Methods: This study included patients aged ≤40 with ATAAD who underwent surgical treatment at our institution between 2015 and 2019. The patients were categorized into groups according to heritable thoracic aortic disease (HTAD) presence or absence.
Trauma Case Rep
February 2025
Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, 1-3-1 Wakinohamakaigandori, Chuo-ku, Kobe, Hyogo 651-0073, Japan.
Background: Hybrid emergency rooms (ERs) allow computed tomography (CT) scanning, interventional radiology, and surgery all in the same suite. Severe trauma patients with blunt thoracic aortic injury (BTAI) require rapid diagnosis and treatment. Hybrid ERs allow the potential for clinicians to implement multiple therapeutic procedures, including thoracic endovascular aortic repair (TEVAR), for these types of conditions without the need to transport the patients.
View Article and Find Full Text PDFExp Physiol
January 2025
Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK.
Fenestrated/branched endovascular aortic repair emerges as the primary therapeutic modality for intricate aortic pathologies encompassing the paravisceral and thoracoabdominal segments, where bridging stent grafts (BSGs) play a vital role in linking the primary aortic endograft with target vessels. Bridging stent grafts can be categorized mainly into self-expanding stent grafts (SESGs) and balloon-expandable stent grafts (BESGs). Physiological factors significantly influence post-complex endovascular aortic repair BSG behaviour, impacting clinical outcomes of SESGs and BESGs in different but overlapping ways.
View Article and Find Full Text PDFEur J Cardiothorac Surg
January 2025
Department of Cardiothoracic Surgery, Division of Heart and Lung Disease, Utrecht University Medical Center, Utrecht, The Netherlands.
Objective: Aortic valve repair/sparing have been established as effective treatments for aortic regurgitation and/or aortic aneurysms. However, concerns remain regarding long-term durability, reproducibility, and patient selection. This study aims to asses long-term clinical and echocardiographic outcomes, with a focus on aortic regurgitation grade and left ventricular ejection fraction evolution, in adults undergoing these procedures.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!