Long-term outcomes of infrarenal endovascular aneurysm repair with a commercially available stent graft

Abdulrasak, Mohammed; Sonesson, Björn; Singh, Bharti; Resch, Timothy; Dias, Nuno

doi:10.1016/j.jvs.2019.09.061

Cited by 10 publications

(4 citation statements)

References 26 publications

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“…The rate of freedom from aortic events was significantly higher in the OAR group than in the EVAR group in both the total cohort and propensity score-matched cohort. The re-intervention rate for OAR is reportedly 2.0–18%, and that of EVAR is 16–28% [ 5 , 7 , 22 , 23 , 26 , 27 ], although the definition of re-intervention varies among studies. Our study found that the re-intervention rate of OAR was 7.2%, and that of EVAR was 15% (p < 0.0001).…”

Section: Discussionmentioning

confidence: 99%

Japanese single-center experience of abdominal aortic aneurysm repair over 20 years: should open or endovascular aneurysm repair be performed first?

et al. 2023

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Purpose The present study analyzed the outcomes of our experience with abdominal aortic aneurysm (AAA) repair over 20 years using endovascular aortic repair (EVAR) with commercially available devices or open aortic repair (OAR) and reviewed our surgical strategy for AAA. Methods From 1999 to 2019, 1077 patients (659 OAR, 418 EVAR) underwent AAA repair. The OAR and EVAR groups were compared retrospectively, and a propensity matching analysis was performed. Results EVAR was first introduced in 2008. Our strategy was changed to an EVAR-first strategy in 2010. Beginning in 2018, this EVAR-first strategy was changed to an OAR-first strategy. After propensity matching, the overall survival in the OAR group was significantly better than that in the EVAR group at 10 years (p = 0.006). Two late deaths due to AAA rupture were identified in the EVAR group, although there were no significant differences between the OAR and EVAR groups with regard to the freedom from AAA-related death at 10 years. The rate of freedom from aortic events at 10 years was significantly higher in the OAR group than in the EVAR group (p < 0.0001). Conclusion The rates of freedom from AAA-related death in both the OAR and EVAR groups were favorable, and the rate of freedom from aortic events was significantly lower in the EVAR group than in the OAR group. Close long-term follow-up after EVAR is mandatory.

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Section: Discussionmentioning

confidence: 99%

Japanese single-center experience of abdominal aortic aneurysm repair over 20 years: should open or endovascular aneurysm repair be performed first?

et al. 2023

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“…The aim of AAA repair by either surgical or endovascular techniques is to reduce the risk of rupture and death [ 8 ]. Through the development of EVAR, we can perform this safely and with improved morbidity and mortality compared to traditional open repair [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Open Repair of a Large Abdominal Aortic Aneurysm With a Type 2 Endoleak After an Endovascular Aortic Aneurysm Repair: A Case Report and Literature Review

Elbayoumi,

Farres,

Erben

2023

Cureus

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“…This last concept is reinforced by similar findings seen for patients undergoing infrarenal EVAR. 17 More importantly, the failure of the proximal seal after FEVAR appears to be rare when an adequate sealing zone is chosen for the original FEVAR 18 and most centres are currently liberal in having the repair incorporating all the renovisceral segment with 1.5 to two covered stents extending above the most cranial fenestration in the initial repair. This has been shown not to increase the risks significantly 19 at the same time that it allows a future proximal extension to be done with a simple TEVAR instead of requiring a very complex F/BEVAR in FEVAR when only a part of the renovisceral segment was included.…”

Section: Discussionmentioning

confidence: 99%

Editor's Choice – Multicentre Outcomes of Redo Fenestrated/Branched Endovascular Aneurysm Repair to Rescue Failed Fenestrated Endografts

Karelis

Haulon

Sonesson

et al. 2021

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDSThis study describes the promising feasibility and outcomes of proximal extension with new fenestrated/ branched endovascular aneurysm repair (FEVAR/BEVAR) inside a previous failing FEVAR in many experienced aortic centres. Some of the technical challenges determined the technical success and further re-interventions were needed, but clinical success was high with no aneurysm related mortality. This establishes a baseline for comparison with other therapeutic options.Objective: To report the outcomes of redo fenestrated and/or branched endovascular aortic repair (F/BEVAR in FEVAR) to rescue previous failed FEVAR. Methods: Retrospective review of all consecutive patients undergoing F/BEVAR in FEVAR at eight aortic centres including pre-, intra-, and post-operative data according to a pre-established protocol. Follow up consisted of at least yearly computed tomography angiography. Values are presented as median and interquartile range, and survival as estimate AE standard error in percentage. Results: 18 male patients (76 years old; range 69 e 78 years) receiving FEVAR involving two (two or three) target vessels between 2006 and 2016 underwent F/BEVAR in FEVAR between 2012 and 2019 (aneurysm diameter of 63 mm; range 56 e 69 mm). Median interval between the procedures was 53 (29 e 103) months. The indication for F/BEVAR in FEVAR was type Ia endoleak in 16 cases (eight isolated and eight combined with graft migration), one graft migration without endoleak and one migration with significant proximal aortic expansion. F/BEVAR in FEVAR involved all patent renovisceral arteries and had an operating time of 260 (204 e 344) minutes. Technical success was achieved in 15 (83%) cases. There was a failure to bridge one renal artery, one renal capsular bleed with the subsequent need for renal artery embolisation within 24 hours and one persistent type Ib endoleak despite iliac extension. There was no peri-or in hospital death. Two patients developed spinal cord ischaemia, one transient paraparesis and one permanent paraplegia. The latter occurred in a non-staged procedure where spinal drainage was used. During a follow up of 27 (7 e 39) months, three (17%) patients underwent late re-interventions. Overall survival at 24 months was 70 AE 11% with no aneurysm related death and a secondary clinical success at 24 months of 84 AE 11%. Conclusion: F/BEVAR in FEVAR is a technically challenging but feasible solution to rescue failed FEVAR. The outcomes are promising in many aortic centres but need to be confirmed by further studies with longer follow up.

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Long-term outcomes of infrarenal endovascular aneurysm repair with a commercially available stent graft

Cited by 10 publications

References 26 publications

Japanese single-center experience of abdominal aortic aneurysm repair over 20 years: should open or endovascular aneurysm repair be performed first?

Japanese single-center experience of abdominal aortic aneurysm repair over 20 years: should open or endovascular aneurysm repair be performed first?

Open Repair of a Large Abdominal Aortic Aneurysm With a Type 2 Endoleak After an Endovascular Aortic Aneurysm Repair: A Case Report and Literature Review

Editor's Choice – Multicentre Outcomes of Redo Fenestrated/Branched Endovascular Aneurysm Repair to Rescue Failed Fenestrated Endografts

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