Shipra Arya¹, Dawn M. Coleman¹, Jordan Knepper¹, Peter K. Henke¹, Gilbert R. Upchurch², John E. Rectenwald¹, Enrique Criado¹, Jonathan L. Eliason¹, Katherine Gallagher^1
1Vascular Surgery, University of Michigan, Ann Arbor, MI; ²University of Virginia, Charlottesville, VA.

OBJECTIVES: This study compares our experience with explantation of aortic endografts for endoleak vs. infection.

METHODS: The medical records of 1,500 aortic procedures performed at our center were queried from 2002-2011. Relevant data from patients needing explantation of aortic endografts was analyzed.

RESULTS: Thirty-six patients underwent aortic explantation (63.9% male). Mean age was 71.6 years with a mean aneurysm size of 6.6cm (range 3.5-10.7 cm). Hypertension (97%), hyperlipidemia (77.8%) and smoking (83%) were the most prevalent risk factors. Mean time to explant was 45.3 months (range 2.2-118.4 months). The primary explant indication was endoleak in 24 (66.7%) and infection in 12 (33.3%) patients. Thirty-day morbidity was 54% (endoleak) and 83% (infection). There were 2 deaths (16.7%) in the infection group within 30 days. Five patients were symptomatic, while 2 patients had ruptured aneurysms. In the endoleak group, there were 9 type Ia, 7 type II, 1 type III, 3 type V, 1 rupture and 3 patients with multiple endoleaks. Seventy-eight percent of patients were alive at a mean follow-up of 17. 4 months.

CONCLUSIONS: This is the largest endograft explantation series to date. Patients with an infectious etiology have significantly worse morbidity and mortality than patients requiring explantation for endoleaks.

AUTHOR DISCLOSURES: S. Arya, Nothing to disclose; D. M. Coleman, Nothing to disclose; E. Criado, Nothing to disclose; J. L. Eliason, Nothing to disclose; K. Gallagher, Nothing to disclose; P. K. Henke, Nothing to disclose; J. Knepper, Nothing to disclose; J. E. Rectenwald, Nothing to disclose; G. R. Upchurch, Nothing to disclose.

Peri-operative variables by indication for explant

Posted April 2012