May J, White G H, Harris J P
Department of Surgery, University of Sydney, Royal Prince Alfred Hospital, New South Wales, Australia.
Semin Vasc Surg. 1999 Sep;12(3):207-14.
Conversion from endoluminal to open repair of abdominal aortic aneurysms (AAA) may be primary, at the original operation or secondary, at a subsequent operation. The indications for primary conversion include aortic rupture and migration of an endograft resulting in obstructed blood flow and irreversible twisting of an endograft. The indications for secondary conversion include persistent endoleak, sealed endoleak with continued AAA expansion, apparently successful AAA repair, with continued expansion and the presence of an infected endograft. The technique of conversion varies from standard repair through modified standard repair to supraceliac control, depending on the cause of failure leading to conversion. All conversion procedures expose the patient to an increased risk and are best avoided by careful case selection, accurate sizing, and good procedural technique.
腹主动脉瘤（AAA）腔内修复转为开放修复可分为原发性（在初次手术时）或继发性（在后续手术时）。原发性转为开放修复的指征包括主动脉破裂、移植物移位导致血流受阻以及移植物不可逆扭转。继发性转为开放修复的指征包括持续内漏、内漏封堵但腹主动脉瘤仍持续扩大、腹主动脉瘤修复看似成功但仍持续扩大以及存在感染的移植物。转为开放修复的技术因导致转为开放修复的失败原因不同而有所差异，从标准修复到改良标准修复，再到腹腔干上方控制。所有转为开放修复的手术都会使患者面临更高的风险，通过仔细的病例选择、准确的尺寸测量和良好的手术技术，最好避免这种情况发生。
