Late open conversions after EVAR: early results of the first year of the newly started iconvert National registry

BacKgrouNd: despite advancements in endovascular materials and techniques, an open conversion (oc) after endovascular aneurysm repair (EVar) is sometimes still required. the aim of this study was to report the early results of a national registry on oc after EVar, describing the characteristics of the population that currently requires these technically challenging operations. MEtHods: the iconvert (Italian conversion registry) started in January 2022, including 21 vascular centers. all consecutive patients undergoing oc were prospectively included. We collected data pre-operatively, post-operatively, at one-month follow-up, and at each follow-up evaluation. We included all patients operated on until december 2022; we analyzed and reported early and in-hospital results. rEsults: We included 74 patients with a mean age of 77.81±6.32 years (93.24% males). Median time elapsed from initial EVar was 74.07 months (IQr 48.93-108). Endovascular repair was attempted in 59.46% (44/74) prior to loc. Median aneurysm diameter at conversion was 80 mm (IQr 61-89). the main indication for loc was the presence of an endoleak (62/75, 83.78%). complex EVar was present in 6/74 (8.11%) of the patients. fifty-two patients (70.27%) underwent partial endograft explantation. overall 30-day death rate was 14.86% (11/74). thirty-day mortality was 20.83% for urgent cases vs. 12% for elective cases. In-hospital mortality was 17.57% (13/74). coNclusIoNs: current oc after EVar seem to be different if compared to previous reports from 2000s and 2010s. they are performed later, patients present with larger aneurysms, and we are also starting to face the need of complex EVar explantations.