Fenestrated and branched grafts for para-anastomotic aortic aneurysm repair.
OBJECTIVE
To investigate the use of fenestration and branch artery stenting during endovascular stent-graft repair of para-anastomotic aneurysms (PAA).


METHODS
A retrospective review was conducted of 9 patients (all men; mean age 71 years, range 60-80) who received custom-designed fenestrated endoprostheses for PAA repair. Eight tubular fenestrated devices and 1 composite device (fenestrated tube plus modular bifurcated body) with a total of 31 fenestrations were used.


RESULTS
The mean operating time was 318+/-93 minutes (range 220-485); the mean fluoroscopy time was 77+/-38 minutes (range 39-158), during which a mean 121+/-81 mL (range 33-300) of contrast was used. Technical success was achieved in all cases. Over a mean follow-up of 12+/-5.5 months (range 6-24), 1 secondary intervention was carried out due to a break in a side branch stent-graft; 2 transient renal impairments and 1 permanent renal insufficiency unrelated to renal artery patency were observed. So far, no vessel loss has emerged.


CONCLUSIONS
Conventional repair of PAA has been a standard procedure for many years, though it carries high surgical risk as well as perioperative mortality. Fenestrated endografts may be a promising alternative in selected patients.
Ziegler
Peter
P
Städtische Kliniken, Franfurt a.M. Höchst, Germany. Peter.Ziegler@skfh.de
Perdikides
Theodossios P
TP
Avgerinos
Efthimios D
ED
Umscheid
Thomas
T
Stelter
Wolf J
WJ
D000368:Aged; D000714:Anastomosis, Surgical; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D015641:Radiography, Interventional; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome