title: Fenestrated endovascular aortic repair for juxtarenal abdominal aortic aneurysm.
abstract: BACKGROUND
  Endovascular stent-graft with fenestration can improve proximal sealing in patients with juxtarenal abdominal aortic aneurysm (JAAA). The purpose of this study was to describe our primary experience and evaluate the safety and efficacy of fenestrated device for JAAA in high-risk patients.
  
  
  METHODS
  Between March 2011 and May 2012, nine male patients (mean age, (79.6 ± 8.6) years) with asymptomatic JAAAs underwent elective deployment of the Zenith fenestrated stent-grafts at a single institution. All patients were treated in the hybrid operating room under general anesthesia. Follow-up computed tomography angiography (CTA) was routinely performed before discharge, at 3, 6, and 12 months and annually thereafter.
  
  
  RESULTS
  Procedural success was achieved in all cases. Total sixteen small fenestrations, two large fenestrations and eight scallops were used. Intra-operative complications occurred in four patients, which included one proximal type I endoleak, two type II endoleaks, and one renal artery dissection. The mean hospital stay was (8.9 ± 1.4) days, mean blood loss was (360.5 ± 46.8) ml, and mean iodinated contrast volume was (230.6 ± 58.3) ml. The mean follow-up time was (7.6 ± 4.2) months. The visceral graft patency was 100% until now. One patient had an increase of serum creatinine of more than 30%, but did not require dialysis. No patients died, no stent fractured, and migration were diagnosed during the follow-up.
  
  
  CONCLUSIONS
  The early results of fenestrated device for high-risk patients with complex JAAAs are satisfactory. However, long-term fenestrated graft durability and branch vessel patency remain to be determined.
authors: Department of Vascular Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China. pla301dml@vip.sina.com
authors: Wei
authors: W
authors: Guo
authors: Hong-peng
authors: HP
authors: Zhang
authors: Xiao-ping
authors: XP
authors: Liu
authors: Xin
authors: X
authors: Jia
authors: Jiang
authors: J
authors: Xiong
authors: Xiao-hui
authors: XH
authors: Ma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D016896:Treatment Outcome