Impact of stent-graft complexity on mid-term results in fenestrated endovascular aortic repair of juxtarenal and suprarenal abdominal aortic aneurysms.


Journal

The Journal of cardiovascular surgery
ISSN: 1827-191X
Titre abrégé: J Cardiovasc Surg (Torino)
Pays: Italy
ID NLM: 0066127

Informations de publication

Date de publication:
Jun 2023
Historique:
medline: 2 6 2023
pubmed: 16 9 2022
entrez: 15 9 2022
Statut: ppublish

Résumé

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. A single center retrospective study was conducted on 154 patients, who underwent FEVAR from 2006 to 2020 at our institution. 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*cm 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.

Sections du résumé

BACKGROUND 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 METHODS
A single center retrospective study was conducted on 154 patients, who underwent FEVAR from 2006 to 2020 at our institution.
RESULTS 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*cm
CONCLUSIONS 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.

Identifiants

pubmed: 36106397
pii: S0021-9509.22.12311-6
doi: 10.23736/S0021-9509.22.12311-6
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

268-278

Auteurs

Ozan Yazar (O)

Department of Vascular Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.
Department of Vascular Surgery, Zuyderland Medical Center, Heerlen, the Netherlands.

Gabriela Pilz da Cunha (G)

Department of Vascular Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.

Michiel W de Haan (MW)

Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands.

Barend M Mees (BM)

Department of Vascular Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.

Geert W Schurink (GW)

Department of Vascular Surgery, Maastricht University Medical Center, Maastricht, the Netherlands - gwh.schurink@mumc.nl.

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