Endosalvage Technique Based on Overhaul Concepts for Late Complications after Endovascular Abdominal Aortic Aneurysm Repair

Abstract

Endovascular aortic repair (EVAR) for abdominal aortic aneurysm has an early survival benefit but an inferior late survival compared with open repair. To improve results for late survival after EVAR it is necessary to prevent secondary aneurysm rupture. Significant risk factors for secondary rupture were type I A endoleak, type III endoleak, graft migration, and postoperative kinking of the endograft. Surgical treatment is necessary for some of these patients. The aim of this article is to introduce an overhaul concept - that is a treatment strategy for possible etiology of sac expansion with/without type II endoleaks-, and secondary endovascular treatment for late type 1 endoleak and IIIb endoleak.