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. 2022 Sep 23;11(19):5596.
doi: 10.3390/jcm11195596.

Mid-Term Results of Fenestrated Endovascular Repair after Prior Open Aortic Reconstruction

Pablo Marques de Marino  1 , Melad Abu Jiries  1 , Pavel Tesinsky  1 , Anas Ibraheem  1 , Athanasios Katsargyris  1 , Eric L Verhoeven  1
Affiliations

Mid-Term Results of Fenestrated Endovascular Repair after Prior Open Aortic Reconstruction

Pablo Marques de Marino et al. J Clin Med. .

Abstract

This study aims to assess the mid-term results of fenestrated endovascular aneurysm repair (FEVAR) for the treatment of proximal aortic pathology after previous open surgical repair (OSR). All patients with a previous history of OSR of an abdominal aortic aneurysm undergoing a FEVAR procedure between October 2010 and November 2021 were included. The endpoints of the study were technical success, mortality, target vessel patency and reinterventions during follow-up. Thirty-five patients (34 male, mean age 72.9 ± 7 years) were included. The median interval from the primary surgery to the FEVAR procedure was 136 months (range 47-261). The indication for treatment was a para-anastomotic aneurysm in 18 (51%) patients and a true aneurysm due to progression of disease in 17 (49%) patients. Technical success was achieved in 33 (94%) patients. There was one (3%) early death due to postoperative bleeding from a renal artery. Estimated survival at 12, 24 and 36 months was 89.1% ± 6%, 84.4% ± 7.3% and 84.4% ± 7.3%, respectively. There was no aneurysm-related mortality. One (3%) target vessel occluded during follow-up and three (9%) patients underwent late reinterventions. In conclusion, FEVAR is a safe and effective alternative for the endovascular treatment of para-anastomotic aneurysms/pseudoaneurysms after OSR showing high technical success, low mortality and morbidity, and good mid-term outcomes.

Keywords: abdominal aortic aneurysm; endovascular procedures; fenestrated endovascular aneurysm repair; juxtarenal aortic aneurysm; para-anastomotic aneurysm; previous aortic repair.

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Conflict of interest statement

Eric LG Verhoeven has received research grants from Cook Inc., and honoraria as a speaker and consultant from Cook Inc, W.L. Gore & Ass, Maquet-Getinge, Bentley InnoMed and Siemens Healthineers. Athanasios Katsargyris has received honoraria as a speaker for Cook Inc.

Figures

Figure 1
Figure 1
Para-anastomotic aneurysm in a patient with a short body in the previous surgical graft (arrow) and control angiography after treatment with a fenestrated stent graft and a bifurcated device with an inverted limb.
Figure 2
Figure 2
Kaplan–Meyer analysis of patient survival during follow-up.
Figure 3
Figure 3
Kaplan–Meyer analysis of target vessel primary patency during follow-up.
Figure 4
Figure 4
Kaplan–Meyer analysis of freedom from reintervention during follow-up.
See this image and copyright information in PMC

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