Nationwide Experience with EVAS Relining of Previous Open or Endovascular AAA Treatment in The Netherlands
Objective: Relining of a previously placed surgical graft or endograft for an abdominal aortic aneurysm (AAA) is a reintervention to treat progression of disease or failure of the primary (endo)graft. Endovascular Aneurysm Sealing (EVAS) relining is a technique with potential advantages due to the absence of a bifurcation, the possibility for a unilateral approach, and sealing concept of the endobags. The purpose of this study was to describe the nationwide experience with EVAS relining of previous AAA repair in the Netherlands. Methods: A retrospective analysis of all patients who underwent E... Mehr ...
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Dokumenttyp: | Artikel |
Erscheinungsdatum: | 2022 |
Reihe/Periodikum: | Ketting , S , Zoethout , A C , Heyligers , J M M , Wiersema , A M , Yeung , K K , Schurink , G W H , Verhagen , H J M , de Vries , J P P M , Reijnen , M M P J & Mees , B M E 2022 , ' Nationwide Experience with EVAS Relining of Previous Open or Endovascular AAA Treatment in The Netherlands ' , Annals of Vascular Surgery , vol. 84 , pp. 250-264 . https://doi.org/10.1016/j.avsg.2021.12.077 |
Sprache: | Englisch |
Permalink: | https://search.fid-benelux.de/Record/base-29624631 |
Datenquelle: | BASE; Originalkatalog |
Powered By: | BASE |
Link(s) : | https://pure.eur.nl/en/publications/a7bdd425-eb79-4a3d-b260-096904879b3d |
Objective: Relining of a previously placed surgical graft or endograft for an abdominal aortic aneurysm (AAA) is a reintervention to treat progression of disease or failure of the primary (endo)graft. Endovascular Aneurysm Sealing (EVAS) relining is a technique with potential advantages due to the absence of a bifurcation, the possibility for a unilateral approach, and sealing concept of the endobags. The purpose of this study was to describe the nationwide experience with EVAS relining of previous AAA repair in the Netherlands. Methods: A retrospective analysis of all patients who underwent EVAS relining in 7 high volume vascular centres in the Netherlands between 2014 and 2019 was performed. Primary outcomes were technical and clinical success. Secondary outcomes were perioperative outcomes, complications and survival. Results: Thirty-three patients underwent EVAS relining of open (n = 10) or endovascular (n = 23) repair. 26 were elective cases, 5 were urgent and 2 were acute (ruptured). Mean time between primary treatment and EVAS relining was 99 ± 74 months. Indications after open repair were proximal progression of disease (n = 7) and graft defect (n = 3). Indications after EVAR were type IA (n = 10), type IB (n = 3), type IIIA (n = 4), type IIIB (n = 3) endoleak, and endotension (n = 3). 18 patients underwent regular EVAS, 4 unilateral EVAS and 11 chimney-EVAS. In-hospital mortality was 6% (both patients with rAAA). Technical success was achieved in 97%. Median follow-up after EVAS relining was 20 months (range 0-43). Freedom from reintervention at 1-year and 2-year were 83% and 61% and the estimated survival 79% and 71%, respectively. EVAS relining after open repair had a clinical success of 90% at 1-year and of 70% at latest follow-up, while after EVAR clinical success rates were 70% and 52%, respectively. Conclusion: EVAS relining of previous AAA repair is associated with high technical success, however with limited clinical success at median follow-up of 20 months. Clinical success was higher in ...