title: Fenestrated aortic endografts for juxtarenal aortic aneurysm: medium term outcomes.
abstract: OBJECTIVE
  The utility of fenestrated-endovascular aneurysm repair (FEVAR) remains uncertain. This study examines the medium term outcomes of patients undergoing FEVAR for asymptomatic juxtarenal abdominal aortic aneurysm (AAA).
  
  
  METHODS
  Consecutive patients undergoing elective FEVAR for juxtarenal AAA at a single tertiary centre were studied between October 2005 and March 2010. Patients were followed up for at least six-months within a protocol including clinical examination, laboratory studies, CT and duplex imaging, and abdominal radiographs. Outcomes were assessed in terms of survival, target vessel patency and graft related complications.
  
  
  RESULTS
  Twenty-nine patients were analysed on an intention to treat basis. There were 27 men and two women of median (range) age 74 (54-86) years. Mean (SD) aneurysm diameter was 68 (7) mm. Median (range) ASA score was 3 (2-4). No procedures required conversion to an open procedure, but one procedure was abandoned. Seventy-nine visceral vessels were perfused through a fabric fenestration or scallop. All vessels remained patent at completion angiography. No patients died within 30-days of surgery. During follow up there were four (14%) deaths at a median (range) of 17 (8-21) months after aneurysm repair. None of these deaths were aneurysm related. Eighteen (62%) patients suffered one or more graft related complications, of whom 11 (38%) required one or more early or late reintervention.
  
  
  CONCLUSIONS
  Fenestrated aortic endografts can be utilized safely in the management of juxtarenal AAA in patients at high-risk for open surgery. However, the rate of graft related complication and reintervention is high at medium term follow up.
authors.affiliation: Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK. andrew.tambyraja@ed.ac.uk
authors.forename: A L
authors.initials: AL
authors.lastname: Tambyraja
authors.forename: N G
authors.initials: NG
authors.lastname: Fishwick
authors.forename: M J
authors.initials: MJ
authors.lastname: Bown
authors.forename: A
authors.initials: A
authors.lastname: Nasim
authors.forename: M J
authors.initials: MJ
authors.lastname: McCarthy
authors.forename: R D
authors.initials: RD
authors.lastname: Sayers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency