Intravascular Lithotripsy Versus Open Surgical Conduit in the Management of Complex Access Vessels During Advanced Endovascular Aortic Repair

Hostile-access vessel anatomy represents a critical issue in advanced endovascular treatment of complex aortic diseases. The purpose this study is to compare early outcomes surgical iliac conduit vs intravascular lithotripsy (IVL) the management challenging arteries during aneurysm repair (EVAR). All patients who underwent EVAR for disease with access vessels (angulation >90°, circumferential calcifications extended more than 50% length, hemodynamic stenosis, or occlusions) were included present study. Pre-, intra-, and postoperative data collected into dedicated database retrospectively analyzed. Incidence complications, reinterventions mortality recorded. From January 2020 March 2022, 103 procedures at our clinic. Eighteen (17.4%) had diseased vessels. Surgical was used eight (44.4%, group A), whereas 10 (55.6%, B), IVL used. Technical success achieved all cases; there no cases re-intervention. average duration surgery A 355.62 ± 128.83 minutes, B, it 200 74.94 minutes (P < .001). hospital stay 12.56 days: A, 17.12 days 8.9 days; P .03. Cumulative 30 11.1% (two from B). Our experience shows that safe effective when compared open bypass reduce operative time intraoperative complications.