title: Endovascular repair of complex aortic aneurysms.
abstract: BACKGROUND
  Surgery for complex aortic aneurysms (thoracoabdominal, juxtarenal and pseudoaneurysms) is associated with a high morbidity and mortality rate. Branched and fenestrated stent grafts constitute a new technology intended as an alternative treatment for this disease.
  
  
  OBJECTIVE
  To describe a single-center experience with fenestrated and branched endografts for the treatment of complex aortic aneurysms.
  
  
  METHODS
  We reviewed all cases of complex aortic aneurysms treated with branched or fenestrated devices in our center. Data collected included device specifics, perioperative morbidity and mortality, re-intervention rates and mid-term results.
  
  
  RESULTS
  Between 2007 and 2012 nine patients were treated with branched and fenestrated stent grafts. Mean age was 73 years. Mean aneurysm size was 63 mm. Perioperative mortality was 22% (2/9). During the follow-up, re-interventions were required in 3 patients (33%). Of 34 visceral artery branches 33 remained patent, resulting in a patency rate of 97%. Sac expansion was seen in a single patient due to a large endoleak. No late aneurysm-related deaths occurred.
  
  
  CONCLUSIONS
  Branched and fenestrated stent grafts are feasible and relatively safe alternatives for the treatment of complex aortic aneurysms involving the visceral segment. Further research is needed to determine the long-term durability of this new technology.
authors.affiliation: Department of Vascular Surgery, Sheba Medical Center, Tel Hashomer. Silverberg_d@msn.com
authors.forename: Daniel
authors.initials: D
authors.lastname: Silverberg
authors.affiliation: Department of Anaesthesia and Intensive Care, Sheba Medical Center, Tel Hashomer.
authors.forename: Violeta
authors.initials: V
authors.lastname: Glauber
authors.affiliation: Department of lnvasive Radiology, Sheba Medical Center, Tel Hashomer.
authors.forename: Uri
authors.initials: U
authors.lastname: Rimon
authors.affiliation: Department of Vascular Surgery, Sheba Medical Center, Tel Hashomer.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Yakubovitch
authors.affiliation: Department of Vascular Surgery, Sheba Medical Center, Tel Hashomer.
authors.forename: Emanuel R
authors.initials: ER
authors.lastname: Reinitz
authors.affiliation: Department of Vascular Surgery, Sheba Medical Center, Tel Hashomer.
authors.forename: Basheer
authors.initials: B
authors.lastname: Sheick-Yousif
authors.affiliation: Department of lnvasive Radiology, Sheba Medical Center, Tel Hashomer.
authors.forename: Boris
authors.initials: B
authors.lastname: Khaitovich
authors.affiliation: Department of Vascular Surgery, Sheba Medical Center, Tel Hashomer.
authors.forename: Jacob
authors.initials: J
authors.lastname: Schneiderman
authors.affiliation: Department of Vascular Surgery, Sheba Medical Center, Tel Hashomer.
authors.forename: Moshe
authors.initials: M
authors.lastname: Halak
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000473:pathology / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000473:pathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000473:pathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D016208:Databases, Factual; D057510:Endovascular Procedures / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome