Postoperative Outcomes and Reinterventions Following Fenestrated/Branched Endovascular Aortic Repair in Post-Dissection and Complex Degenerative Abdominal and Thoraco-Abdominal Aortic Aneurysms

Benfor, Bright; Hoegl, Julia; Gouveia e Melo, Ryan; Stana, Jan; Prendes, Carlota Fernandez; Pichlmaier, Maximilian; Rantner, Barbara und Tsilimparis, Nikolaos (2022): Postoperative Outcomes and Reinterventions Following Fenestrated/Branched Endovascular Aortic Repair in Post-Dissection and Complex Degenerative Abdominal and Thoraco-Abdominal Aortic Aneurysms. In: Journal of Clinical Medicine, Bd. 11, Nr. 16, 4768

Abstract

Background: The outcome of FBEVAR in post-dissection thoracoabdominal aortic aneurysms has not been well established in the literature. The aim of this study was to compare midterm outcomes following FBEVAR in post-dissection aneurysms to degenerative aneurysms. (2) Methods: This was a retrospective review of all patients undergoing FBEVAR in a single center between 2017 and 2020. The baseline characteristics, intraoperative details, and postoperative outcomes of patients with post-dissection aneurysms were compared to those with degenerative outcomes. The primary end point was unplanned reinterventions. Cox regression analysis was performed to identify the determinants of worse outcomes. Results: A total of 137 subjects with a mean age of 70 +/- 10 years were included in the study, out of which 30 presented post-dissection aneurysms (22%). Custom-made devices were employed in 119 patients, off-the-shelf devices in 13 and physician-modified endografts in 5, with incorporation in 505 target vessels. The technical success rate was comparable in both groups (97% vs. 98%, p = 0.21). However, the one-year freedom from unplanned reintervention was lower in the post-dissection group (67% vs. 89%, p = 0.011). Conclusion: FBEVAR in post-dissection aneurysms is associated with a favorable technical success rate, but reintervention rates remain high. Long procedural duration and the use of adjunctive techniques are associated with increased risk of reinterventions.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Sprache: Englisch