Timothy H Liao1, Jennifer J Watson1, M Ashraf Mansour2, Robert F Cuff1, Shonda L Banegas1, Christopher M Chambers1, Jason D Slaikeu1, Peter Y Wong1. 1. Department of Surgery, Spectrum Health Medical Group, Grand Rapids Medical Education Partners, Michigan State University College of Human Medicine, Grand Rapids, MI, USA. 2. Department of Surgery, Spectrum Health Medical Group, Grand Rapids Medical Education Partners, Michigan State University College of Human Medicine, Grand Rapids, MI, USA. Electronic address: Ashraf.mansour@spectrumhealth.org.
Abstract
BACKGROUND: Patients with juxtarenal aortic aneurysms who are unfit for open repair may be considered for fenestrated endovascular repair (fenEVAR). We report our initial experience with fenEVAR. METHODS: We reviewed the data on all our patients receiving fenEVAR for juxtarenal aortic aneurysms. RESULTS: Eight patients, average age 75 years, underwent fenEVAR. Endografts were designed from details obtained from preoperative computed tomography angiography. There were 6 grafts with superior mesenteric scallops and bilateral renal fenestrations, 1 with bilateral renal scallops, and 1 with a single renal fenestration. All patients survived 30 days. There was no renal failure requiring dialysis. At 10 weeks, 1 patient died from acute intestinal ischemia and multisystem organ failure, and another died from respiratory failure. CONCLUSIONS: It is feasible to offer fenEVAR to patients who are poor candidates for open repair. However, these procedures are technically challenging. Early outcomes are less favorable than other aortic endovascular procedures.
BACKGROUND:Patients with juxtarenal aortic aneurysms who are unfit for open repair may be considered for fenestrated endovascular repair (fenEVAR). We report our initial experience with fenEVAR. METHODS: We reviewed the data on all our patients receiving fenEVAR for juxtarenal aortic aneurysms. RESULTS: Eight patients, average age 75 years, underwent fenEVAR. Endografts were designed from details obtained from preoperative computed tomography angiography. There were 6 grafts with superior mesenteric scallops and bilateral renal fenestrations, 1 with bilateral renal scallops, and 1 with a single renal fenestration. All patients survived 30 days. There was no renal failure requiring dialysis. At 10 weeks, 1 patient died from acute intestinal ischemia and multisystem organ failure, and another died from respiratory failure. CONCLUSIONS: It is feasible to offer fenEVAR to patients who are poor candidates for open repair. However, these procedures are technically challenging. Early outcomes are less favorable than other aortic endovascular procedures.