European Multicentric Experience with Fenestrated-Branched ENDOvascular Stent-grafting after Previous FAILed Infrarenal Aortic Repair

TY - JOUR

T1 - European Multicentric Experience with Fenestrated-Branched ENDOvascular Stent-grafting after Previous FAILed Infrarenal Aortic Repair

T2 - the EU-FBENDO-FAIL Registry

AU - Budtz-Lilly, Jacob

AU - D'Oria, Mario

AU - Gallitto, Enrico

AU - Bertoglio, Luca

AU - Kölbel, Tilo

AU - Lindström, David

AU - Dias, Nuno

AU - Lundberg, Goran

AU - Böckler, Dittmar

AU - Parlani, Gianbattista

AU - Antonello, Michele

AU - Veraldi, Gian Franco

AU - Tsilimparis, Nikolaos

AU - Kotelis, Drosos

AU - Dueppers, Philip

AU - Tinelli, Giovanni

AU - Ippoliti, Arnaldo

AU - Spath, Paolo

AU - Logiacco, Antonino

AU - Schurink, Geert Willem H

AU - Chiesa, Roberto

AU - Grandi, Alessandro

AU - Panuccio, Giuseppe

AU - Rohlffs, Fiona

AU - Wanhainen, Anders

AU - Mani, Kevin

AU - Karelis, Angelos

AU - Sonesson, Björn

AU - Jonsson, Magnus

AU - Bresler, Alina-Marilena

AU - Simonte, Gioele

AU - Isernia, Giacomo

AU - Xodo, Andrea

AU - Mezzetto, Luca

AU - Mastrorilli, Davide

AU - Prendes, Carlota Fernandez

AU - Chaikouni, Basel

AU - Zimmermann, Alexander

AU - Lepidi, Sandro

AU - Gargiulo, Mauro

AU - Mees, Barend

AU - Unosson, Jon

N1 - Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

PY - 2023/8/1

Y1 - 2023/8/1

N2 - OBJECTIVE: To report the mid-term outcomes of fenestrated-branched endovascular aneurysm repair (F-BEVAR) following a failed previous endovascular aneurysm repair (pEVAR) or previous open aneurysm repair (pOAR).METHODS: Data from consecutive patients who underwent F-BEVAR for pEVAR or pOAR from 2006 to 2021 from 17 European vascular centers were analyzed. Endpoints included technical success, major adverse events, 30-day mortality, and 5-year estimates of survival, target vessel primary patency, freedom from reinterventions, type I/III endoleaks, and sac growth >5 mm.BACKGROUND: Treatment of a failed previous abdominal aortic aneurysm repair is a complex undertaking. F-BEVAR is becoming an increasingly attractive option, although comparative data are limited regarding associated risk factors, indications for treatment, and various outcomes.RESULTS: There were 526 patients included, 268 pOAR and 258 pEVAR. The median time from previous repair to F-BEVAR was 7 (interquartile range, 4-12) years, 5 (3-8) for pEVAR, and 10 (6-14) for pOAR, P <0.001. Predominant indication for treatment was type Ia endoleak for pEVAR and progression of the disease for pOAR. Technical success was 92.8%, pOAR (92.2%), and pEVAR (93.4%), P =0.58. The 30-day mortality was 6.5% overall, 6.7% for pOAR, and 6.2% for pEVAR, P =0.81. There were 1853 treated target vessels with 5-year estimates of primary patency of 94.4%, pEVAR (95.2%), and pOAR (94.4%), P =0.03. Five-year estimates for freedom from type I/III endoleaks were similar between groups; freedom from reintervention was lower for pEVAR (38.3%) than for pOAR (56.0%), P =0.004. The most common indication for reinterventions was for type I/III endoleaks (37.5%).CONCLUSIONS: Repair of a failed pEVAR or pOARis safe and feasible with comparable technical success and survival rates. While successful treatment can be achieved, significant rates of reintervention should be anticipated, particularly for issues related to instability of target vessels/bridging stents.

AB - OBJECTIVE: To report the mid-term outcomes of fenestrated-branched endovascular aneurysm repair (F-BEVAR) following a failed previous endovascular aneurysm repair (pEVAR) or previous open aneurysm repair (pOAR).METHODS: Data from consecutive patients who underwent F-BEVAR for pEVAR or pOAR from 2006 to 2021 from 17 European vascular centers were analyzed. Endpoints included technical success, major adverse events, 30-day mortality, and 5-year estimates of survival, target vessel primary patency, freedom from reinterventions, type I/III endoleaks, and sac growth >5 mm.BACKGROUND: Treatment of a failed previous abdominal aortic aneurysm repair is a complex undertaking. F-BEVAR is becoming an increasingly attractive option, although comparative data are limited regarding associated risk factors, indications for treatment, and various outcomes.RESULTS: There were 526 patients included, 268 pOAR and 258 pEVAR. The median time from previous repair to F-BEVAR was 7 (interquartile range, 4-12) years, 5 (3-8) for pEVAR, and 10 (6-14) for pOAR, P <0.001. Predominant indication for treatment was type Ia endoleak for pEVAR and progression of the disease for pOAR. Technical success was 92.8%, pOAR (92.2%), and pEVAR (93.4%), P =0.58. The 30-day mortality was 6.5% overall, 6.7% for pOAR, and 6.2% for pEVAR, P =0.81. There were 1853 treated target vessels with 5-year estimates of primary patency of 94.4%, pEVAR (95.2%), and pOAR (94.4%), P =0.03. Five-year estimates for freedom from type I/III endoleaks were similar between groups; freedom from reintervention was lower for pEVAR (38.3%) than for pOAR (56.0%), P =0.004. The most common indication for reinterventions was for type I/III endoleaks (37.5%).CONCLUSIONS: Repair of a failed pEVAR or pOARis safe and feasible with comparable technical success and survival rates. While successful treatment can be achieved, significant rates of reintervention should be anticipated, particularly for issues related to instability of target vessels/bridging stents.

U2 - 10.1097/SLA.0000000000005577

DO - 10.1097/SLA.0000000000005577

M3 - SCORING: Journal article

C2 - 35837956

VL - 278

SP - e389-e395

JO - ANN SURG

JF - ANN SURG

SN - 0003-4932

IS - 2

ER -