title: Fenestrated endovascular repair of complex aortic aneurysms.
abstract: BACKGROUND
  Fenestrated endovascular aneurysm repair (FEVAR) provides an endovascular solution for patients with large abdominal aortic aneurysms and challenging neck anatomy in addition to repair of endoleaks and pseudoaneurysms. This article reports the midterm outcomes of FEVAR from a single-tertiary referral centre in Ireland.
  
  
  METHODS
  From 2006 to 2012, nine consecutive asymptomatic patients with neck anatomy unfavourable for standard EVAR underwent endovascular repair with a customised fenestrated Zenith stent graft. An additional three patients had fenestrated grafts for repair of pseudoaneurysms (n = 2) following open AAA repair and a type I endoleak (n = 1). All patients were prospectively enrolled in a computerised database. Outcomes including mortality, morbidity, renal function, target vessel patency, endoleak and reintervention were analysed.
  
  
  RESULTS
  The mean age and aneurysm size in the primary repair group were 74 years (65-84 years) and 6 cm (5-8.3 cm), respectively, and in the secondary repair group, the mean age was 66 years (61-75 years). No procedures required open conversion, and no visceral arteries were lost. On completion angiography, two patients in group 1 had a type I endoleak and one had a type III endoleak. There were no endoleaks in the secondary repair group. Follow-up ranged from 30 days to 6 years. There was one death within 30 days (8 %) and two deaths at 3 years from non-aneurysm-related causes. Six patients required secondary interventions. Three patients had a transient post-operative creatinine rise of >30 %.
  
  
  CONCLUSIONS
  Our study supports FEVAR as a feasible and effective therapy in the management of patients with complex aortic aneurysms.
authors.affiliation: St James's Hospital, Dublin, Ireland, ccanning@rcsi.ie.
authors.forename: C
authors.initials: C
authors.lastname: Canning
authors.forename: Z
authors.initials: Z
authors.lastname: Martin
authors.forename: M P
authors.initials: MP
authors.lastname: Colgan
authors.forename: O
authors.initials: O
authors.lastname: Abdulrahim
authors.forename: M
authors.initials: M
authors.lastname: McCafferty
authors.forename: J
authors.initials: J
authors.lastname: Fitzpatrick
authors.forename: S N
authors.initials: SN
authors.lastname: Haider
authors.forename: P
authors.initials: P
authors.lastname: Madhavan
authors.forename: S
authors.initials: S
authors.lastname: O'Neill
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome