TY - JOUR
T1 - European Multicentric Experience with Fenestrated-Branched ENDOvascular Stent-grafting after Previous FAILed Infrarenal Aortic Repair
T2 - the EU-FBENDO-FAIL Registry
AU - Budtz-Lilly, Jacob
AU - D'Oria, Mario
AU - Gallitto, Enrico
AU - Bertoglio, Luca
AU - Kölbel, Tilo
AU - Lindström, David
AU - Dias, Nuno
AU - Lundberg, Goran
AU - Böckler, Dittmar
AU - Parlani, Gianbattista
AU - Antonello, Michele
AU - Veraldi, Gian Franco
AU - Tsilimparis, Nikolaos
AU - Kotelis, Drosos
AU - Dueppers, Philip
AU - Tinelli, Giovanni
AU - Ippoliti, Arnaldo
AU - Spath, Paolo
AU - Logiacco, Antonino
AU - Schurink, Geert Willem H
AU - Chiesa, Roberto
AU - Grandi, Alessandro
AU - Panuccio, Giuseppe
AU - Rohlffs, Fiona
AU - Wanhainen, Anders
AU - Mani, Kevin
AU - Karelis, Angelos
AU - Sonesson, Björn
AU - Jonsson, Magnus
AU - Bresler, Alina-Marilena
AU - Simonte, Gioele
AU - Isernia, Giacomo
AU - Xodo, Andrea
AU - Mezzetto, Luca
AU - Mastrorilli, Davide
AU - Prendes, Carlota Fernandez
AU - Chaikouni, Basel
AU - Zimmermann, Alexander
AU - Lepidi, Sandro
AU - Gargiulo, Mauro
AU - Mees, Barend
AU - Unosson, Jon
N1 - Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - Objective: To report the mid-term outcomes of fenestrated-branched endovascular aneurysm repair (F-BEVAR) following a failed previous endovascular aneurysm repair (pEVAR) or previous open aneurysm repair (pOAR). Methods: Data from consecutive patients who underwent F-BEVAR for pEVAR or pOAR from 2006 to 2021 from 17 European vascular centers were analyzed. Endpoints included technical success, major adverse events, 30-day mortality, and 5-year estimates of survival, target vessel primary patency, freedom from reinterventions, type I/III endoleaks, and sac growth >5 mm. Background: Treatment of a failed previous abdominal aortic aneurysm repair is a complex undertaking. F-BEVAR is becoming an increasingly attractive option, although comparative data are limited regarding associated risk factors, indications for treatment, and various outcomes. Results: There were 526 patients included, 268 pOAR and 258 pEVAR. The median time from previous repair to F-BEVAR was 7 (interquartile range, 4-12) years, 5 (3-8) for pEVAR, and 10 (6-14) for pOAR, P<0.001. Predominant indication for treatment was type Ia endoleak for pEVAR and progression of the disease for pOAR. Technical success was 92.8%, pOAR (92.2%), and pEVAR (93.4%), P=0.58. The 30-day mortality was 6.5% overall, 6.7% for pOAR, and 6.2% for pEVAR, P=0.81. There were 1853 treated target vessels with 5-year estimates of primary patency of 94.4%, pEVAR (95.2%), and pOAR (94.4%), P=0.03. Five-year estimates for freedom from type I/III endoleaks were similar between groups; freedom from reintervention was lower for pEVAR (38.3%) than for pOAR (56.0%), P=0.004. The most common indication for reinterventions was for type I/III endoleaks (37.5%). Conclusions: Repair of a failed pEVAR or pOARis safe and feasible with comparable technical success and survival rates. While successful treatment can be achieved, significant rates of reintervention should be anticipated, particularly for issues related to instability of target vessels/bridging stents.
AB - Objective: To report the mid-term outcomes of fenestrated-branched endovascular aneurysm repair (F-BEVAR) following a failed previous endovascular aneurysm repair (pEVAR) or previous open aneurysm repair (pOAR). Methods: Data from consecutive patients who underwent F-BEVAR for pEVAR or pOAR from 2006 to 2021 from 17 European vascular centers were analyzed. Endpoints included technical success, major adverse events, 30-day mortality, and 5-year estimates of survival, target vessel primary patency, freedom from reinterventions, type I/III endoleaks, and sac growth >5 mm. Background: Treatment of a failed previous abdominal aortic aneurysm repair is a complex undertaking. F-BEVAR is becoming an increasingly attractive option, although comparative data are limited regarding associated risk factors, indications for treatment, and various outcomes. Results: There were 526 patients included, 268 pOAR and 258 pEVAR. The median time from previous repair to F-BEVAR was 7 (interquartile range, 4-12) years, 5 (3-8) for pEVAR, and 10 (6-14) for pOAR, P<0.001. Predominant indication for treatment was type Ia endoleak for pEVAR and progression of the disease for pOAR. Technical success was 92.8%, pOAR (92.2%), and pEVAR (93.4%), P=0.58. The 30-day mortality was 6.5% overall, 6.7% for pOAR, and 6.2% for pEVAR, P=0.81. There were 1853 treated target vessels with 5-year estimates of primary patency of 94.4%, pEVAR (95.2%), and pOAR (94.4%), P=0.03. Five-year estimates for freedom from type I/III endoleaks were similar between groups; freedom from reintervention was lower for pEVAR (38.3%) than for pOAR (56.0%), P=0.004. The most common indication for reinterventions was for type I/III endoleaks (37.5%). Conclusions: Repair of a failed pEVAR or pOARis safe and feasible with comparable technical success and survival rates. While successful treatment can be achieved, significant rates of reintervention should be anticipated, particularly for issues related to instability of target vessels/bridging stents.
U2 - 10.1097/SLA.0000000000005577
DO - 10.1097/SLA.0000000000005577
M3 - Article
C2 - 35837956
SN - 0003-4932
VL - 278
SP - E389-E395
JO - Annals of Surgery
JF - Annals of Surgery
IS - 2
ER -