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Endovascular Aneurysm Repair Using Fenestrated Endografts

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Mastering Endovascular Techniques

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Abstract

The mainstream adoption of fenestrated endografts (FEVAR) has led to the widespread endovascular treatment of juxtarenal and paravisceral aortic aneurysms and other aortic pathology that previously would have required open repair. Even more so than with infrarenal EVAR, patient selection, careful planning, and understanding of potential complications are paramount for successful FEVAR. The availability of commercially available devices varies by geographic region, but most will incorporate at least two fenestrations and typically more if treatment of the full visceral segment is required. Physician-modified endografts remain an option for patients who cannot fit a commercially available device or who require expedited repair.

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References

  1. Browne TF, Hartley D, Purchas S, Rosenberg M, van Schie G, Lawrence-Brown M. Endovascular and surgical techniques a fenestrated covered suprarenal aortic stent. Eur J Vasc Endovasc Surg. 1999;18:445–9.

    Article  CAS  PubMed  Google Scholar 

  2. Park JH, Chung JW, Choo IW, Kim SJ, Lee JY, Han MC. Fenestrated stent-grafts for preserving visceral arterial branches in the treatment of abdominal aortic aneurysms: preliminary experience. J Vasc Interv Radiol. 1996;7:819–23.

    Article  CAS  PubMed  Google Scholar 

  3. Doonan RJ, Girsowicz E, Dubois L, Gill HL. A systematic review and meta-analysis of endovascular juxtarenal aortic aneurysm repair demonstrates lower perioperative mortality compared with open repair. J Vasc Surg. 2019;70:2054–2064.e3.

    Article  PubMed  Google Scholar 

  4. Giménez-Gaibar A, González-Cañas E, Solanich-Valldaura T, Herranz-Pinilla C, Rioja-Artal S, Ferraz-Huguet E. Could preoperative neck anatomy influence follow-up of EVAR? Ann Vasc Surg. 2017;43:127–33. https://doi.org/10.1016/j.avsg.2016.12.011.

    Article  PubMed  Google Scholar 

  5. Caradu C, Erard XB, Midy D, Ducasse E, Bordeaux F. Influence of anatomic angulations in chimney and fenestrated endovascular aneurysm repair. Ann Vasc Surg. 2017;43:104–14. https://doi.org/10.1016/j.avsg.2017.01.002.

    Article  PubMed  Google Scholar 

  6. Chaikof EL, Fillinger MF, Matsumura JS, et al. Identifying and grading factors that modify the outcome of endovascular aortic aneurysm repair. J Vasc Surg. 2002;35:1061–6.

    Article  PubMed  Google Scholar 

  7. Marone EM, Freyrie A, Ruotolo C, Michelagnoli S, Antonello M, Speziale F, Veroux P, Gargiulo M, Gaggiano A, Vasc A. Expert opinion on hostile neck definition in endovascular treatment of abdominal aortic aneurysms (a Delphi consensus). Ann Vasc Surg. 2020;62:173–82.

    Article  PubMed  Google Scholar 

  8. Oliveira NFG, Gonçalves FB, Ultee K, Pinto JP, Josee van Rijn M, ten Raa S, Mwipatayi P, Böckler D, Hoeks SE, Verhagen HJM. Patients with large neck diameter have a higher risk of type IA endoleaks and aneurysm rupture after standard endovascular aneurysm repair. J Vasc Surg. 2019;69(3):783–91.

    Article  PubMed  Google Scholar 

  9. Oliveira NFG, Oliveira-Pinto J, van Rijn MJ, Baart S, ten Raa S, Hoeks SE, Bastos Gonçalves F, Verhagen HJM. Risk factors, dynamics, and clinical consequences of aortic neck dilatation after standard endovascular aneurysm repair. Eur J Vasc Endovasc Surg. 2021;62:26. https://doi.org/10.1016/j.ejvs.2021.03.020.

    Article  PubMed  Google Scholar 

  10. Antoniou GA, Georgiadis GS, Antoniou SA, Kuhan G, Murray D. A meta-analysis of outcomes of endovascular abdominal aortic aneurysm repair in patients with hostile and friendly neck anatomy. J Vasc Surg. 2013;57:527–38.

    Article  PubMed  Google Scholar 

  11. O’Donnell TFX, McElroy IE, Boitano LT, Mohebali J, Lamuraglia GM, Kwolek CJ, Conrad MF. Comparison of treatment options for aortic necks outside standard endovascular aneurysm repair instructions for use. J Vasc Surg. 2021;74:1548–57.

    Article  PubMed  Google Scholar 

  12. Oderich GS, Forbes TL, Chaer R, Davies MG, Lindsay TF, Mastracci T, Singh MJ, Timaran C, Woo EY. Reporting standards for endovascular aortic repair of aneurysms involving the renal-mesenteric arteries. J Vasc Surg. 2021;73:4S–52S.

    Article  PubMed  Google Scholar 

  13. Oderich GS, Greenberg RK, Farber M, Lyden S, Sanchez L, Fairman R, Jia F, Bharadwaj P. Results of the United States multicenter prospective study evaluating the Zenith fenestrated endovascular graft for treatment of juxtarenal abdominal aortic aneurysms. J Vasc Surg. 2014;60:1420–1428.e5.

    Article  PubMed  Google Scholar 

  14. Wang SK, Gutwein AR, Gupta AK, Lemmon GW, Sawchuk AP, Motaganahalli RL, Murphy MP, Fajardo A. Institutional experience with the Zenith Fenestrated aortic stent graft. J Vasc Surg. 2018;68(2):331–6. https://doi.org/10.1016/j.jvs.2017.11.063.

    Article  PubMed  Google Scholar 

  15. Stern JR, Deslarzes-Dubuis C, Tran K, Lee JT. Fenestrated aortic aneurysm repair in patients treated inside versus outside of instructions for use. 2022. https://doi.org/10.1177/15266028211068762. https://doi-org.pitt.idm.oclc.org/101177/15266028211068762.

  16. van Calster K, Bianchini A, Elias F, Hertault A, Azzaoui R, Fabre D, Sobocinski J, Haulon S. Risk factors for early and late mortality after fenestrated and branched endovascular repair of complex aneurysms. J Vasc Surg. 2019;69:1342–55.

    Article  PubMed  Google Scholar 

  17. Katsargyris A, Oikonomou K, Kouvelos G, Mufty H, Ritter W, Verhoeven ELG. Comparison of outcomes for double fenestrated endovascular aneurysm repair versus triple or quadruple fenestrated endovascular aneurysm repair in the treatment of complex abdominal aortic aneurysms. J Vasc Surg. 2017;66:29–36.

    Article  PubMed  Google Scholar 

  18. Motta F, Oderich GS, Tenorio ER, Schanzer A, Timaran CH, Schneider D, Sweet MP, Beck AW, Eagleton MJ, Farber MA. Fenestrated-branched endovascular aortic repair is a safe and effective option for octogenarians in treating complex aortic aneurysm compared with nonoctogenarians. J Vasc Surg. 2021;74:353–362.e1.

    Article  PubMed  Google Scholar 

  19. Jubouri M, Surkhi AO, Tan SZCP, Bailey DM, Williams IM, Bashir M. Abdominal aortic aneurysm: can the Anacondaâ„¢ custom-made device deliver? An international perspective. Front Cardiovasc Med. 2022;9:959149. https://doi.org/10.3389/fcvm.2022.959149.

    Article  PubMed  PubMed Central  Google Scholar 

  20. de Niet A, Zeebregts CJ, Reijnen MMPJ, et al. Outcomes after treatment of complex aortic abdominal aneurysms with the fenestrated Anaconda endograft. J Vasc Surg. 2020;72:25–35.e1.

    Article  PubMed  Google Scholar 

  21. Panuccio G, Schanzer A, Rohlffs F, Heidemann F, Wessels B, Schurink GW, van Herwaarden JA, Kölbel T. Endovascular navigation with fiber optic RealShape technology. J Vasc Surg. 2022;75:e234. https://doi.org/10.1016/J.JVS.2022.08.002.

    Article  Google Scholar 

  22. Chamseddin K, Timaran CH, Oderich GS, et al. Comparison of upper extremity and transfemoral access for fenestrated-branched endovascular aortic repair. J Vasc Surg. 2022;77:704. https://doi.org/10.1016/j.jvs.2022.10.009.

    Article  PubMed  Google Scholar 

  23. Scott CK, Driessen AL, Gonzalez MS, Malekpour F, Guardiola GG, Baig MS, Kirkwood ML, Timaran CH. Perioperative neurologic outcomes of right versus left upper extremity access for fenestrated-branched endovascular aortic aneurysm repair. J Vasc Surg. 2022;75:794–802.

    Article  PubMed  Google Scholar 

  24. Price LZ, Safir SR, Faries PL, McKinsey JF, Tang GHL, Tadros RO. Shockwave lithotripsy facilitates large-bore vascular access through calcified arteries. J Vasc Surg Cases Innov Tech. 2021;7:164–70.

    Article  PubMed  Google Scholar 

  25. van der Riet C, Schuurmann RCL, Verhoeven ELG, Zeebregts CJ, Tielliu IFJ, Bokkers RPH, Katsargyris A, de Vries JPPM. Outcomes of Advanta V12 covered stents after fenestrated endovascular aneurysm repair. J Endovasc Ther. 2021;28:700–6.

    Article  PubMed  Google Scholar 

  26. Torsello GF, Herten M, Müller M, Frank A, Torsello GB, Austermann M. Comparison of the biomechanical properties of the Advanta V12/iCast and Viabahn stent-grafts as bridging devices in fenestrated endografts: an in vitro study. J Endovasc Ther. 2020;27:258–65.

    Article  PubMed  Google Scholar 

  27. Torsello G, Müller M, Litterscheid S, Berekoven B, Austermann M, Torsello GF. Fatigue resistance of the Advanta V12/iCast and Viabahn balloon-expandable stent-graft as bridging stents in experimental fenestrated endografting. J Endovasc Ther. 2021;28:463–8. https://doi.org.pitt.idm.oclc.org/101177/1526602821996724.

    Article  PubMed  Google Scholar 

  28. Torsello GF, Beropoulis E, Munaò R, Trimarchi S, Torsello GB, Austermann M. Outcomes of bridging stent grafts in fenestrated and branched endovascular aortic repair. J Vasc Surg. 2020;72:859–65.

    Article  PubMed  Google Scholar 

  29. Deslarzes-Dubuis C, Tran K, Colvard BD, Lee JT. Renal stent complications and impact on renal function following standard fenestrated endovascular aneurysm repair. Ann Vasc Surg. 2020;72:106. https://doi.org/10.1016/j.avsg.2020.10.020.

    Article  PubMed  Google Scholar 

  30. Spear R, Sobocinski J, Hertault A, Delloye M, Azzauiu R, Fabre D, Haulon S. One year outcomes of 101 BeGraft stent grafts used as bridging stents in fenestrated endovascular repairs. Eur J Vasc Endovasc Surg. 2018;55:504–10.

    Article  PubMed  Google Scholar 

  31. Clough RE, Spear R, Mougin J, le Houérou T, Fabre D, Sobocinski J, Haulon S. Midterm outcomes of BeGraft stent grafts used as bridging stents in fenestrated endovascular aortic aneurysm repair. J Endovasc Ther. 2022;30:592. https://doi.org/10.1177/15266028221091894/ASSET/IMAGES/LARGE/10.1177_15266028221091894-FIG2.JPEG.

    Article  PubMed  Google Scholar 

  32. Abel D, Farb A. Application of investigational device exemptions regulations to endograft modification. J Vasc Surg. 2013;57:823–5.

    Article  PubMed  Google Scholar 

  33. Starnes BW, Tatum B, Singh N. Procedural and perioperative results in patients treated with fenestrated endovascular aneurysm repair planned by automated software in a physician-sponsored investigational device exemption trial of physician-modified endografts. J Vasc Surg. 2018;68:1297–307.

    Article  PubMed  Google Scholar 

  34. Oderich GS, Ribeiro MS, Sandri GA, Tenorio ER, Hofer JM, Mendes BC, Chini J, Cha S. Evolution from physician-modified to company-manufactured fenestrated-branched endografts to treat pararenal and thoracoabdominal aortic aneurysms. J Vasc Surg. 2018;70:31. https://doi.org/10.1016/j.jvs.2018.09.063.

    Article  PubMed  Google Scholar 

  35. Dossabhoy SS, Simons JP, Flahive JM, Aiello FA, Sheth P, Arous EJ, Messina LM, Schanzer A. Fenestrated endovascular aortic aneurysm repair using physician-modified endovascular grafts versus company-manufactured devices. J Vasc Surg. 2018;67:1673–83.

    Article  PubMed  Google Scholar 

  36. Hemingway JF, Starnes BW, Kline BR, Singh N. Initial experience with the Terumo aortic Treo device for fenestrated endovascular aneurysm repair. J Vasc Surg. 2021;74:823–831.e1.

    Article  PubMed  Google Scholar 

  37. Coles-Black J, Barber T, Bolton D, Chuen J. A systematic review of 3D printed template-assisted physician modified stent grafts for FEVAR. J Vasc Surg. 2021;74(1):296–306.e1.

    Article  PubMed  Google Scholar 

  38. Gouveia e Melo R, Fernández Prendes C, Caldeira D, Stana J, Rantner B, Wanhainen A, Oderich GS, Tsilimparis N. Systematic review and meta-analysis of physician modified endografts for treatment of thoraco-abdominal and complex abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2022;64:188–99.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Vascular Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Nathan L. Liang, Fanny S. Alie-Cusson & Karim M. Salem

  2. Division of Vascular Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA

    Karim M. Salem

Authors
  1. Nathan L. Liang
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  2. Fanny S. Alie-Cusson
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  3. Karim M. Salem
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Corresponding author

Correspondence to Nathan L. Liang .

Editor information

Editors and Affiliations

  1. National and Kapodistrian University of Athens, Athens, Greece

    George Geroulakos

  2. Department of Vascular Surgery, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece

    Efthymios Avgerinos

  3. Henri Mondor Hôspital, APHP Créteil, Hôpital Privé Paris East, Ramsay Santé, Créteil, France

    Jean Pierre Becquemin

  4. Vascular and Interventional Radiology, Guy's and St Thomas' NHS Foundation Trust, London, UK

    Gregory C. Makris

  5. Vascular Surgery, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy

    Alberto Froio

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Liang, N.L., Alie-Cusson, F.S., Salem, K.M. (2024). Endovascular Aneurysm Repair Using Fenestrated Endografts. In: Geroulakos, G., Avgerinos, E., Becquemin, J.P., Makris, G.C., Froio, A. (eds) Mastering Endovascular Techniques. Springer, Cham. https://doi.org/10.1007/978-3-031-42735-0_51

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  • DOI: https://doi.org/10.1007/978-3-031-42735-0_51

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  • Online ISBN: 978-3-031-42735-0

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