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The rate of reintervention following open surgery for abdominal aortic aneurysm (AAA) is approximately 2% in the first 5 years. The need for reoperation usually develops later (more than 10 years post surgery) with open repair than with EVAR. Reintervention for repair following EVAR for abdominal aortic aneurysm is necessary in up to 10 - 20% of patients per year. The repair can often be done with a catheter (endovascular) thus avoiding open surgery.

There are several situations for which reintervention following EVAR may be necessary, including:

• Endoleaks
• Enlargement of aneurysm
• If the aorta changes shape (e.g. twists) and reduces the blood flow to a limb
• The stent-graft device may move or may separate at its connecting joints
• Stent may deteriorate over time
• Infection around the stent
• Rupture of the AAA

Late conversions from EVAR to open surgery for reintervention of complications following the original surgical procedure occur in an estimated 1% to 2% of patients each year and carry a higher mortality risk. The most common reasons for the conversion to open surgical repair include:

• Migration of stent
• Infection of the stent-graft
• AAA enlargement
• AAA rupture

For some high-risk patients, delaying elective open AAA repair is recommended if they are not eligible for EVAR.