Long-term Follow-up of Secondary Interventions After Endovascular Aneurysm Repair With the AneuRx Endoprosthesis: A Single-Center Experience

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Purpose:To evaluate initial and long-term results of secondary interventions after endovascular aneurysm repair (EVAR) with an AneuRx endoprosthesis.Methods:Between 1996 and 2003, an AneuRx device was used primarily in 212 patients (197 men; mean age 71±7.0 years). Sixty-two (29%) patients (58 men; mean age 73±7.2 years) required a secondary intervention (percutaneous, endovascular, or open repair) after EVAR and were prospectively followed after their secondary interventions. Data were analyzed retrospectively.Results:Of the 212 AneuRx patients, 59 (28%) required secondary interventions for endoleaks (28 type la, 6 type lb, 8 type II, and 17 type III) and 3 (1%) for obstruction of the endoprosthesis. The mean interval between primary EVAR and secondary intervention was 39±30 months. The yearly risk of requiring a secondary intervention after receiving a primary AneuRx graft was 3.7%. Overall 30-day morbidity after a secondary intervention was 18% (11/62); the 30-day mortality was 5% (3/62). Short endovascular extender cuffs were used for type la endoleaks in 23 of 28 patients. Over a mean follow-up of 81±34 months after the secondary intervention, the success of short endovascular cuffs for treatment of type la endoleak was 52% (12/23); the remaining 11 (48%) patients required additional reinterventions for recurrent endoleak or persistent aneurysm growth.Conclusion:Patients with a primary AneuRx stent-graft had an acceptable yearly risk of requiring a secondary intervention following EVAR, but 30-day morbidity and mortality rates were significant and must be taken into account during primary decision making for endovascular or open repair. Proximal extender cuffs may not be a durable treatment for type la endoleak.J Endovasc Ther. 2010;17:408-415

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