Academic Journal
Fenestrated Endovascular Aortic Repair After Failed Endovascular Aortic Repair
| العنوان: | Fenestrated Endovascular Aortic Repair After Failed Endovascular Aortic Repair |
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| المؤلفون: | Taher, Fadi, Plimon, Markus, Walter, Corinna, Weiss, Gabriel, Kliewer, Miriam, Assadian, Afshin, Falkensammer, Juergen |
| المصدر: | Journal of Endovascular Therapy ; page 152660282311741 ; ISSN 1526-6028 1545-1550 |
| بيانات النشر: | SAGE Publications |
| سنة النشر: | 2023 |
| الوصف: | Purpose: Fenestrated endovascular aortic repair (FEVAR) is technically more challenging when performed after a failing EVAR procedure (FEVAR after EVAR). This study aims to assess the technical outcome of FEVAR after EVAR and to identify factors that may influence complication rates. Methods: A retrospective observational study was conducted at a single department of vascular and endovascular surgery. The rate of FEVAR after EVAR compared to primary FEVAR is reported. Complication and primary unconnected fenestration (PUF) rates as well as survival were assessed for the FEVAR after EVAR cohort. PUF rates and operating time were also compared to all primary FEVAR patients. Patient characteristics and technical factors such as number of fenestrations or use of a steerable sheath were assessed as possible influencers on technical success when performing FEVAR after EVAR. Results: Two hundred and nine fenestrated devices were implanted during the study period (2013 to April 2020). Thirty-five patients (16.7% of all FEVAR patients) had undergone FEVAR after EVAR and were included in the study. Overall survival at last follow-up (20.2±19.1 months) was 82.9% in FEVAR after EVAR patients. Rates of technical failure dropped significantly after 14 procedures (42.9% vs. 9.5%; p=0.03). Primary unconnected fenestrations were seen in 3 cases of FEVAR after EVAR (8.6%) and 14 of 174 primary FEVAR cases (8.0%; p>0.99). Operating time for FEVAR after EVAR was significantly higher than for primary FEVAR (301.1±110.5 minutes vs. 253.9±103.4 minutes; p=0.02). The availability of a steerable sheath was a significant predictor of reduced risk of PUFs, whereas age and gender, number of fenestrations or suprarenal fixation of the failed EVAR did not significantly influence PUF rates. Conclusion: Fewer technical complications were seen over the study period in FEVAR after EVAR patients. While rates of PUFs were not different from primary FEVAR, operating time was significantly longer in patients undergoing FEVAR for failed EVAR. ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1177/15266028231174113 |
| الاتاحة: | http://dx.doi.org/10.1177/15266028231174113 http://journals.sagepub.com/doi/pdf/10.1177/15266028231174113 http://journals.sagepub.com/doi/full-xml/10.1177/15266028231174113 |
| Rights: | http://journals.sagepub.com/page/policies/text-and-data-mining-license |
| رقم الانضمام: | edsbas.4657031C |
| قاعدة البيانات: | BASE |
| DOI: | 10.1177/15266028231174113 |
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