Multicenter comparison between open conversions and semi-conversions for late endoleaks after endovascular aneurysm repair

Objective: The aim of this study is to compare early and follow-up outcomes late open conversions (LOC, with complete or partial endograft explantation) semi-conversions (SC, preservation) after endovascular aneurysm repair in a multicenter experience. Methods: All LOC SC performed from 1997 2020 11 vascular centers were compared. Endograft infections thrombosis excluded. Primary endpoints mortality long-term survival estimates. Secondary differences postoperative complication rates conversion-related complications during follow-up. Results: In the considered period, 347 patients underwent surgery for complications. Among these, 270 operated on endoleaks (222 LOC, 48 SC). two groups homogeneous terms American Society Anesthesiologists score 3.2 ± 0.7; SC, 3 0.5; P = .128) main characteristics (suprarenal fixation, bifurcated/aorto-uni-iliac configuration). mean age was 75 8 years 79 7 (P .009). Reasons were: 62.2% (138/222) type I endoleak, 21.6% (48/222) II 7.7% (17/222) III 8.5% (19/222) endotension. Indications 64.6% (31/48) 33.3% (16/48) 2.1% (1/48) endoleak. Thirty-day 12.2% (27/222) group, 10.4% (5/48) group .73). Postoperative rate higher (45.5% vs 29.2%; .04). estimated 80% at 1 year 64% 5 years; it 72% 37% (log-rank .01). During median 21.5 months (interquartile range, 2.4-61 months), an endoleak found 38.3% cases; sac growth recorded 27.7% patients. Conclusions: has benefit over reduced but significantly inferior mid-term survival. high persistent and/or recurrent reduce durability.