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

• Published in: Journal of clinical medicine 2022-09, Vol.11 (19), p.5596
• Main Authors: Marques de Marino, Pablo, Abu Jiries, Melad, Tesinsky, Pavel, Ibraheem, Anas, Katsargyris, Athanasios, Verhoeven, Eric L.
• Format: Article
• Language: English
• Subjects: Aortic aneurysms; Clinical medicine; Comorbidity; Coronary vessels; Medical imaging; Mortality; Patients; Success; Surveillance; Tomography; Veins & arteries
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm11195596

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.