Frequency and outcome of re-interventions after endovascular repair for abdominal aortic aneurysm:: A prospective cohort study

Purpose. To describe frequency, type, and outcome of re-intervention after endovascular aortic aneurysm repair (EVAR). Methods. Between September 1996 and December 2003, 308 patients were treated, with data collected prospectively. No patient was lost to follow up, but two were excluded (one primary conversion, and one post-operative death). Vanguard, Talent, Excluder, Zenith, and Quantum devices were used. Follow up required a CT scan before discharge. Initially, a CT scan was done at each follow tip. Subsequently, we used duplex ultrasound and abdominal X-ray, with CT scan used selectively. Results. Mean follow-up was 36 +/- 22 months. Re-interventions were required in 47 (15%) patients, 31 (66%) elective and 16 (34%) emergency cases. In 32 patients, the primary re-intervention zoos successful; in 15 patients an additional 13 secondary and four tertiary re-interventions were required. A total of 72 adjunctive manoeuvres were performed: 49 endovascular (68%) and 23 open (32%). The success of endovascular re-interventions was 80%. The success of open reinterventions was 96%. Open conversions were required in nine patients (3%). There was no mortality. Conclusion. EVAR was associated with a low burden of re-interventions, with only 15% patients requiring re-intervention. Our long-term follow up, without regular CT, was simple and effective.