title: [Results of endovascular repair of TAAA in the first 50  patients].
abstract: BACKGROUND
  Developments with fenestrated and branched stent grafts have opened the way to treat complex aortic aneurysms involving the visceral arteries. First reports on endovascular treatment of thoracoabdominal aneurysms have demonstrated the feasibility of the technique.
  
  
  METHODS
  A literature review and results of first 50  patients treated with a custom-made Zenith device with fixed branches are presented. Most of the patients were refused open surgery mainly for the extent of the disease combined with co-morbidity, which included in most patients a combination of several risk factors. Mean aneurysm size was 71 mm and extent of the aneurysm was type  I (n = 9), type  II (n = 13), type  III (n = 19), and type  IV (n = 9), respectively.
  
  
  RESULTS
  Primary and primary assisted technical successes in our series were 88 % (44 / 50) and 92 % (46 / 50), respectively. One patient died on day  1 from an intraoperative aneurysm rupture. In two patients a renal artery was lost, one due to rupture and one due to malpositioning of the bridging stent graft. In a fourth patient, a celiac artery could not be catheterised and was lost. Finally, in two more patients, catheterisation of in total three renal arteries proved impossible. This was solved by a retrograde approach for two renal arteries via laparotomy in one patient, and a spleno-renal bypass in the other patient. Thirty-day mortality was 8 %. Estimated survival at 6  months, 1  year, and 2  years was 91.2 %, 79.8 %, and 69.7 %, respectively. Freedom of reintervention of all kinds at 1 and 2  years was 81.9 % and 73.7 %, respectively.
  
  
  CONCLUSIONS
  Results of fully endovascular repair of thoracoabdominal aneurysms in a high-risk cohort are promising. A learning curve should be expected. Although longer term results need to be awaited, it is likely that endovascular repair of thoracoabdominal aneurysms will become a preferential treatment option for many patients in the future.
authors.affiliation: Klinikum Nürnberg Süd, Gefäßchirurgie, Nürnberg, Deutschland. eric.verhoeven@klinikumnuernberg.de
authors.forename: E
authors.initials: E
authors.lastname: Verhoeven
authors.forename: I F
authors.initials: IF
authors.lastname: Tielliu
authors.forename: C J
authors.initials: CJ
authors.lastname: Zeebregts
authors.forename: F
authors.initials: F
authors.lastname: Bekkema
authors.forename: G
authors.initials: G
authors.lastname: Vourliotakis
authors.forename: W
authors.initials: W
authors.lastname: Ritter
authors.forename: B
authors.initials: B
authors.lastname: Zipfel
authors.forename: H
authors.initials: H
authors.lastname: Renner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D011474:Prosthesis Design; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery; D015607:Stents