Conventional aortic surgery after endovascular aortic reconstruction

Background: Endovascular therapy of aortic aneurysms is an attractive alternative to conventional aortic surgery. A number of patients, however, will fail endovascular therapy and require open surgical repair.

Methods: We report our experience with conversion to open aortic repair. Of 306 patients given endovascular therapy for an infrarenal aortic aneurysm, 30 (9.8%) required conversion to conventional repair.

Results: Thirteen patients (43.3%) suffered complications, 3 (10%) of which were fatal. Conversion to open aortic repair after endovascular therapy is technically more demanding than primary open repair, particularly because of clamp techniques and stent-extraction.

Conclusions: Emergent conversion operations, especially when preceded by significant retroperitoneal bleeding from vascular tears due to endovascular manipulations are complicated by significant morbidity and mortality.