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Master Thesis

Conversion chirurgicale pour explantation d'endoprothèse de l'aorte abdominale sous rénale : prise en charge et résultats

Abstract : Introduction: the increasing evolution of endovascular AAA treatments has led to an increase in complications, some of which must be treated by open surgery with explantation of the endoprothesis. The objective of this study is to assess the short, medium and long-term results of abdominal aortic stent graft explantations at the Bordeaux University Hospital. Material and method: we carried out a single-center retrospective observational study at the Bordeaux University Hospital from July 2008 to May 2020. All patients who underwent endoprosthesis implantation surgery were included, excluding intraoperative conversions. The patients included had 3 indications: infection, persistent endoleak or endotension and thrombosis. The primary endpoint was the 30-day mortality rate. The secondary outcomes were: in-hospital mortality, overall survival rate, and rate of reinfection in case of infection. Results: 43 patients were included, 93% of whom were men, aged 70 years on average. The most frequent indication was infection in 70% of cases with 37% aorto-digestive fistulas, followed by aneurysm expansion for endoleak in 19% and thrombosis in 12% of cases. The average time to secondary conversion was 34 months, with emergency care in 21% of cases. The 30-day mortality rate was 23%. The rate of in-hospital mortality was 30% and overall 40%. No reinfection was detected during follow-up. Conclusion: secondary conversion therefore appears to be a feasible and reasonable option for the treatment of complications of EVAR in the absence of endovascular solutions. The morbidity of the procedure requires that it be carried out by a trained operator and team, and the management must be multidisciplinary.
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https://dumas.ccsd.cnrs.fr/dumas-03012320
Contributor : Médecine Ub <>
Submitted on : Wednesday, November 18, 2020 - 2:54:24 PM
Last modification on : Saturday, December 19, 2020 - 3:12:50 AM
Long-term archiving on: : Friday, February 19, 2021 - 7:56:08 PM

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  • HAL Id : dumas-03012320, version 1

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Wajih Khalid. Conversion chirurgicale pour explantation d'endoprothèse de l'aorte abdominale sous rénale : prise en charge et résultats. Sciences du Vivant [q-bio]. 2020. ⟨dumas-03012320⟩

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