TY - JOUR
T1 - Impact of stent-graft complexity on mid-term results in fenestrated endovascular aortic repair (FEVAR) of juxtarenal and suprarenal abdominal aortic aneurysms
AU - Yazar, Ozan
AU - Pilz da Cunha, Gabriela
AU - de Haan, Michiel W
AU - Mees, Barend M
AU - Schurink, Geert W
PY - 2023/6/1
Y1 - 2023/6/1
N2 - BACKGROUND: The impact of stent-graft complexity on clinical outcome after fenestrated endovascular aortic aneurysm repair (FEVAR) has been conflicting in the literature. The objective of this study was to compare mid-term results of stent-grafts with renal fenestrations alone with more complex stent-grafts including mesenteric fenestrations. METHODS: A single center retrospective study was conducted on 154 patients, who underwent FEVAR from 2006 to 2020 at our institution. RESULTS: There were 54 (35.1%) patients in the renal FEVAR group and 100 (64.9%) patients in the complex FEVAR group. Median follow-up of the total group was 25 months (IQR 7-45). There were no significant differences in technical success and perioperative mortality. Intraoperative complications (4% vs. 18%, P=0.001), operative time (145 min vs. 191 min, P=0.001), radiation dose (119372 mGy*cm2 vs. 159573 mGy*cm2, P=0.004) and fluoroscopy time (39 min vs. 54 min, P=0.007) were significantly lower in the renal FEVAR group. During follow-up target vessel instability, endoleaks and reinterventions were not significantly different between the two groups. CONCLUSIONS: In this single center retrospective study, renal FEVAR was a safe and effective treatment for patients with juxtarenal AAA demonstrating fewer intraoperative complications and similar mid-term outcomes as complex FEVAR. If the anatomy is compatible for renal FEVAR, it might be unnecessary to expose patients to potentially more complications by choosing a complex FEVAR strategy.
AB - BACKGROUND: The impact of stent-graft complexity on clinical outcome after fenestrated endovascular aortic aneurysm repair (FEVAR) has been conflicting in the literature. The objective of this study was to compare mid-term results of stent-grafts with renal fenestrations alone with more complex stent-grafts including mesenteric fenestrations. METHODS: A single center retrospective study was conducted on 154 patients, who underwent FEVAR from 2006 to 2020 at our institution. RESULTS: There were 54 (35.1%) patients in the renal FEVAR group and 100 (64.9%) patients in the complex FEVAR group. Median follow-up of the total group was 25 months (IQR 7-45). There were no significant differences in technical success and perioperative mortality. Intraoperative complications (4% vs. 18%, P=0.001), operative time (145 min vs. 191 min, P=0.001), radiation dose (119372 mGy*cm2 vs. 159573 mGy*cm2, P=0.004) and fluoroscopy time (39 min vs. 54 min, P=0.007) were significantly lower in the renal FEVAR group. During follow-up target vessel instability, endoleaks and reinterventions were not significantly different between the two groups. CONCLUSIONS: In this single center retrospective study, renal FEVAR was a safe and effective treatment for patients with juxtarenal AAA demonstrating fewer intraoperative complications and similar mid-term outcomes as complex FEVAR. If the anatomy is compatible for renal FEVAR, it might be unnecessary to expose patients to potentially more complications by choosing a complex FEVAR strategy.
U2 - 10.23736/S0021-9509.22.12311-6
DO - 10.23736/S0021-9509.22.12311-6
M3 - Article
C2 - 36106397
SN - 0021-9509
VL - 64
SP - 268
EP - 278
JO - Journal of Cardiovascular Surgery
JF - Journal of Cardiovascular Surgery
IS - 3
ER -