Preoperative Morphological Factors of Thoracic Aortic Aneurysm Sac Enlargement after Endovascular Repair

There were 214 endovascular interventions (71%) for endoleak and disease progression. 89 open interventions were required (29%). Almost half of open interventions were for limb ischaemia or groin complications. Open conversion was required for the majority of ruptures (n 1⁄4 8/10) and continued sac expansion without endoleak (n 1⁄4 33). The mortality associated with open conversion was 10%. This series represents one of the largest in the literature and has a re-intervention rate of 19%, in line with previous reports. Although re-intervention is common, most complications can be successfully treated with endovascular techniques. However, if open abdominal intervention is required, there is a high mortality and the authors therefore propose a ‘stent conserving’ approach to open intervention.