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Vol 9, No 4 (2003)
Research paper
Published online: 2003-09-26

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Secondary interventions after endovascular repair of abdominal aortic aneurysms - causes, predictive factors, and prognosis

Tomasz Zubilewicz, Jean-Pierre Becquemin, Jacek Wroński, Pascal Desgranges, Hischam Kobeiter
Acta Angiologica 2003;9(4):171-182.


Background. The aim of this study was evaluation of secondary interventions defined as procedures performed to close endoleak, or to improve limb patency after endovascular AAA repair and to assess their predictive factors and prognosis.
Material and methods. Patient’s data and follow-up events of all patients who underwent endovascular repair of AAA between January 1995 and November 2001 in our institution were prospectively collected and stored in our database. Patients were divided into two groups according to the presence or absence of secondary reintervention during follow-up. Age, sex, type of AAA, AAA diameter, comorbidities, type of graft and period of treatment were compared using a univariate analysis. Prognosis was assessed by comparison of life table analysis. Interventional success defined as the lack of AAA conversion or rupture were also compared in both groups.
Results. Two hundred and six patients were included in the study. During follow-up, thirty-two patients (16%) required 47 secondary interventions. Respectively 22 and 10 patients were treated with endovascular methods to close various type of endoleaks or were operated on to restore limb blood flow. The only significant predictive factor of secondary reintervention was the type of grafts: early generation 29/101(28.7%) versus the latest generation 3/102 (2.9%). The survival rate was not statistically different in both groups. The interventional success was significantly different 27/32 (84.4%) versus 173/174 (99.4%)
Conclusions. Secondary reinterventions which mainly with early generation grafts improved outcome of endovascular AAA repair in 15% of the cases. However no death could be attributed to these reinterventions or to conversions.

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