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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.99 No.6
- 발행연도
- 2020.12
- 수록면
- 344 - 351 (8page)
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초록· 키워드
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Purpose: Open surgical conversion (OSC) is the last treatment option for patients with endovascular aneurysm repair (EVAR) failure. We investigated the underlying causes of EVAR failure requiring OSC and attempted to determine strategies to avoid OSC after EVAR.
Methods: We retrospectively reviewed the database of patients who underwent OSC after EVAR from 2005 to 2018 in a single institution. Twenty-six OSCs were performed in 24 patients (median age, 74.5 years; 79.2% of males) who had undergone standard EVAR. We investigated pre-, intra-, and postoperative computed tomography or angiographic images and outcomes of the OSCs.
Results: Two main indications for OSC were persistent endoleak (50.0%) and endograft infection (EI) (38.5%). All 13 patients who underwent OSC due to endoleaks received EVAR outside of indications for use. Among 10 patients who underwent OSC due to EI, we found overlooked infection sources in 7 (70.0%) at the time of EVAR or during the surveillance period. OSC was performed at a median of 31.8 months (interquartile range, 9.4-69.8) after EVAR as an emergency (15.4%) or elective (84.6%) surgery. Aortic endograft was removed in 84.6% of cases (totally, 57.7%; partially, 26.9%), whereas it was preserved in 4 cases (15.4%). After 26 OSCs, 2 early deaths (7.7%) and 2 aortoenteric fistulae (7.7%) developed as major complications.
Conclusion: OSC after EVAR was associated with relatively higher perioperative morbidity and mortality. To avoid OSC after EVAR, we recommend careful assessment of coexisting infection sources and avoidance of EVAR for patients with especially unfavorable anatomy for EVAR, particularly the in proximal neck.
Methods: We retrospectively reviewed the database of patients who underwent OSC after EVAR from 2005 to 2018 in a single institution. Twenty-six OSCs were performed in 24 patients (median age, 74.5 years; 79.2% of males) who had undergone standard EVAR. We investigated pre-, intra-, and postoperative computed tomography or angiographic images and outcomes of the OSCs.
Results: Two main indications for OSC were persistent endoleak (50.0%) and endograft infection (EI) (38.5%). All 13 patients who underwent OSC due to endoleaks received EVAR outside of indications for use. Among 10 patients who underwent OSC due to EI, we found overlooked infection sources in 7 (70.0%) at the time of EVAR or during the surveillance period. OSC was performed at a median of 31.8 months (interquartile range, 9.4-69.8) after EVAR as an emergency (15.4%) or elective (84.6%) surgery. Aortic endograft was removed in 84.6% of cases (totally, 57.7%; partially, 26.9%), whereas it was preserved in 4 cases (15.4%). After 26 OSCs, 2 early deaths (7.7%) and 2 aortoenteric fistulae (7.7%) developed as major complications.
Conclusion: OSC after EVAR was associated with relatively higher perioperative morbidity and mortality. To avoid OSC after EVAR, we recommend careful assessment of coexisting infection sources and avoidance of EVAR for patients with especially unfavorable anatomy for EVAR, particularly the in proximal neck.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (29)
참고문헌 신청
Chaikof EL / 2018 / The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm / J Vasc Surg 67:2~77
EVAR Trial Participants / 2005 / Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm(EVAR trial 1) : randomised controlled trial / J Vasc Surg 42:592
Patel R / 2016 / Endovascular versus open repair of abdominal aortic aneurysm in 15-years’follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1):a randomised controlled trial / Lancet 388:2366~2374
Greenhalgh RM / 2004 / Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial / Lancet 364:843~848
Millon A / 2009 / Conversion to open repair after endovascular aneurysm repair: causes and results. A French multicentric study / Eur J Vasc Endovasc Surg 38:429~434
EVAR Trial Participants / 2005 / Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm(EVAR trial 1) : randomised controlled trial / J Vasc Surg 42:592
Patel R / 2016 / Endovascular versus open repair of abdominal aortic aneurysm in 15-years’follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1):a randomised controlled trial / Lancet 388:2366~2374
Greenhalgh RM / 2004 / Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial / Lancet 364:843~848
Millon A / 2009 / Conversion to open repair after endovascular aneurysm repair: causes and results. A French multicentric study / Eur J Vasc Endovasc Surg 38:429~434
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