Endovascular repair of complex aortic aneurysms

Isr Med Assoc J. 2014 Jan;16(1):5-10.

Abstract

Background: Surgery for complex aortic aneurysms (thoracoabdominal, juxtarenal and pseudoaneurysms) is associated with a high morbidity and mortality rate. Branched and fenestrated stent grafts constitute a new technology intended as an alternative treatment for this disease.

Objectives: To describe a single-center experience with fenestrated and branched endografts for the treatment of complex aortic aneurysms.

Methods: We reviewed all cases of complex aortic aneurysms treated with branched or fenestrated devices in our center. Data collected included device specifics, perioperative morbidity and mortality, re-intervention rates and mid-term results.

Results: Between 2007 and 2012 nine patients were treated with branched and fenestrated stent grafts. Mean age was 73 years. Mean aneurysm size was 63 mm. Perioperative mortality was 22% (2/9). During the follow-up, re-interventions were required in 3 patients (33%). Of 34 visceral artery branches 33 remained patent, resulting in a patency rate of 97%. Sac expansion was seen in a single patient due to a large endoleak. No late aneurysm-related deaths occurred.

Conclusions: Branched and fenestrated stent grafts are feasible and relatively safe alternatives for the treatment of complex aortic aneurysms involving the visceral segment. Further research is needed to determine the long-term durability of this new technology.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aneurysm, False / pathology
  • Aneurysm, False / surgery*
  • Aortic Aneurysm, Abdominal / pathology
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortic Aneurysm, Thoracic / pathology
  • Aortic Aneurysm, Thoracic / surgery*
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation / methods
  • Databases, Factual
  • Endovascular Procedures / methods*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Design
  • Stents*
  • Treatment Outcome