Visceral stent patency in fenestrated stent grafting for abdominal aortic aneurysm repair

Grimme, Frederike A.B.; Zeebregts, Clark J.; Verhoeven, Eric L.G.; Bekkema, F.; Reijnen, Michel; Tielliu, Ignace F.J.

doi:10.1016/j.jvs.2013.08.005

Cited by 68 publications

(55 citation statements)

References 27 publications

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“…1 Slightly larger diameters are universally accepted for fenestrated repair of JRAs and paravisceral aneurysms. Indications for treatment with FEVAR include short-necked AAAs (Figure 1), JRAs, or SRAs with diameters ⩾ 55 mm 2,22,30,34,39,40 in men and ⩾ 50 mm 34 or > 45 mm 39 in women. Other described indications are listed in Table 1.…”

Section: Anatomical Criteriamentioning

confidence: 99%

“…39 Mortality has also been correlated with adverse renal events, as shown in several studies. 34,96 Patients experiencing spinal cord ischemia, for example, have a 10 times greater risk of death and notably the majority of those not fully recovered die rapidly. 39 There is also evidence that outcomes are strongly correlated to the level and to the proximal extension of aneurysm disease.…”

Section: Perioperative and Late Mortalitymentioning

confidence: 99%

“…85 Series from referral centers have included between 45 and 607 patients, with 117-1907 target vessels. 5,10,29,[32][33][34]39,80,97 Up to July 2012, a total of 2463 target vessels have been accessed through fenestrations and/or scallops, all within the use of the fenestrated Zenith SG. 20 Overall, early target vessel patency rate ranges from 90.5% to 99.7%.…”

Section: Target Vessel Stenosis/occlusionmentioning

confidence: 99%

“…22 However, stent patency of target vessels must be differentiated from target vessel patency and was reported 95.7% at 1 year and 88.6% at 4 years. 34 In-stent-visceral stenosis/occlusion can be catastrophic with serious clinical sequelae (death, lifelong dialysis, bowel ischemia). Stenting of a fenestration is mandatory to avoid early visceral artery occlusion.…”

Section: Target Vessel Stenosis/occlusionmentioning

confidence: 99%

“…At least for short-necked and juxtarenal aortic aneurysms (JRAs), fenestrated stent-grafting technology has been shown to be feasible, [12][13][14][15][16][17][18][19][20] with published results of highvolume experienced single centers [21][22][23][24][25][26][27][28][29][30][31] and a few recent multicenter trials 32,33 sharing remarkable short-and midterm results, with the durability of the technique being satisfactory (technical success > 95%, low mortality rates averaging 1-2% and low rates of mid-term branch vessel occlusion averaging 4-9%). [25][26][27][28][29]34 Other imaginative procedures have also been developed or modified to allow for the segmental or complete coverage of the aorta in the region of vital branches, including the 'chimney', 'snorkel', 'periscope' [35][36][37] and combined endovascular exclusion and extra-anatomic mesenteric/renal bypasses (hybrid visceral revascularization). 38 The objective of this paper was to provide an up-to-date review on the elective repair of perirenal and TAAAs via the FEVAR approach.…”

mentioning

confidence: 99%

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Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm

et al. 2016

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The introduction of fenestrated stent grafts (SGs) to treat abdominal aortic aneurysms (AAAs) with short proximal necks began in 1999. Nowadays, the whole visceral aorta can be treated totally by endovascular means. The established use of fenestrated devices to treat complex AAAs as a first-line management option has been previously reported. An up-to-date evaluation of the literature was performed including all types of publications regarding the use of fenestrated technology to repair complex AAAs. Fenestrated repair is now an established alternative to hybrid/chimney/snorkel repairs. However, specific criteria and prerequisites are required for the use and improvement of this method. Multiple device morphologies have been used incorporating the visceral arteries in various combinations. This modular strategy connects different devices (bridging covered stents and bifurcated SGs) with the aortic main body, thus excluding the aneurysm from the circulation. Precise deployment of the fenestrated SG is mandatory for successful visceral vessel revascularization. Accurate SG sizing and customization, a high level of technical skill, and facilities with modern imaging techniques including 3D road mapping and dedicated hybrid rooms are required. Most experience has been with the custom-made Zenith Cook platform, although off-the-shelf devices have been recently implanted. More complex repairs have been performed over the last few years, but device complexity has also increased. Perioperative, mid-term, and a few recently reported long-term results are encouraging. Secondary interventions remain the main problem, similar to that observed after traditional endovascular abdominal aortic aneurysm repair (EVAR).

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Section: Anatomical Criteriamentioning

confidence: 99%

Section: Perioperative and Late Mortalitymentioning

confidence: 99%

Section: Target Vessel Stenosis/occlusionmentioning

confidence: 99%

Section: Target Vessel Stenosis/occlusionmentioning

confidence: 99%

mentioning

confidence: 99%

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Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm

et al. 2016

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Meta‐analysis of fenestrated endovascular aneurysm repair versus open surgical repair of juxtarenal abdominal aortic aneurysms over the last 10 years

et al. 2019

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BackgroundJuxtarenal abdominal aortic aneurysms pose a significant challenge whether managed endovascularly or by open surgery. Fenestrated endovascular aneurysm repair (FEVAR) is now well established, but few studies have compared it with open surgical repair (OSR). The aim of this systematic review was to compare short‐ and long‐term outcomes of FEVAR and OSR for the management of juxtarenal aortic aneurysms.MethodsA literature search was conducted of the Ovid Medline, EMBASE and PubMed databases. Reasons for exclusion were series with fewer than 20 patients, studies published before 2007 and those concerning ruptured aneurysms. Owing to variance in definitions, the terms ‘juxta/para/suprarenal’ were used; thoracoabdominal aortic aneurysms were excluded. Primary outcomes were 30‐day/in‐hospital mortality and renal insufficiency. Secondary outcomes included major complication rates, rate of reintervention and rates of endoleak.ResultsTwenty‐seven studies were identified, involving 2974 patients. Study designs included 11 case series, 14 series within retrospective cohort studies, one case–control study and a single prospective non‐randomized trial. The pooled early postoperative mortality rate following FEVAR was 3·3 (95 per cent c.i. 2·0 to 5·0) per cent, compared with 4·2 (2·9 to 5·7) per cent after OSR. After FEVAR, the rate of postoperative renal insufficiency was 16·2 (10·4 to 23·0) per cent, compared with 23·8 (15·2 to 33·6) per cent after OSR. The major early complication rate following FEVAR was 23·1 (16·8 to 30·1) per cent versus 43·5 (34·4 to 52·8) per cent after OSR. The rate of late reintervention after FEVAR was higher than that after OSR: 11·1 (6·7 to 16·4) versus 2·0 (0·6 to 4·3) per cent respectively.ConclusionNo significant difference was noted in 30‐day mortality; however, FEVAR was associated with significantly lower morbidity than OSR. Long‐term durability is a concern, with far higher reintervention rates after FEVAR.

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Thromboembolic Complications During Endovascular Repair of Complex Aortic Aneurysms

Ribeiro

Souza

Oderich

2017

Endovascular Aortic Repair

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Visceral stent patency in fenestrated stent grafting for abdominal aortic aneurysm repair

Cited by 68 publications

References 27 publications

Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm

Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm

Meta‐analysis of fenestrated endovascular aneurysm repair versus open surgical repair of juxtarenal abdominal aortic aneurysms over the last 10 years

Thromboembolic Complications During Endovascular Repair of Complex Aortic Aneurysms

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