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European Multicentric Experience With Fenestrated-branched ENDOvascular Stent Grafting After Previous FAILed Infrarenal Aortic Repair: The EU-FBENDO-FAIL Registry.
Budtz-Lilly, Jacob; D'Oria, Mario; Gallitto, Enrico; Bertoglio, Luca; Kölbel, Tilo; Lindström, David; Dias, Nuno; Lundberg, Goran; Böckler, Dittmar; Parlani, Gianbattista; Antonello, Michele; Veraldi, Gian F; Tsilimparis, Nikolaos; Kotelis, Drosos; Dueppers, Philip; Tinelli, Giovanni; Ippoliti, Arnaldo; Spath, Paolo; Logiacco, Antonino; Schurink, Geert Willem H; Chiesa, Roberto; Grandi, Alessandro; Panuccio, Giuseppe; Rohlffs, Fiona; Wanhainen, Anders; Mani, Kevin; Karelis, Angelos; Sonesson, Björn; Jonsson, Magnus; Bresler, Alina-Marilena; Simonte, Gioele; Isernia, Giacomo; Xodo, Andrea; Mezzetto, Luca; Mastrorilli, Davide; Prendes, Carlota F; Chaikhouni, Basel; Zimmermann, Alexander; Lepidi, Sandro; Gargiulo, Mauro; Mees, Barend; Unosson, Jon.
Afiliación
  • Budtz-Lilly J; Section of Vascular Surgery, Department of Surgical Sciences, University of Uppsala, Uppsala, Sweden.
  • D'Oria M; Division of Vascular Surgery, Department of Cardiovascular Surgery, Aarhus University Hospital, Aarhus, Denmark.
  • Gallitto E; Section of Vascular Surgery, Department of Surgical Sciences, University of Uppsala, Uppsala, Sweden.
  • Bertoglio L; Division of Vascular and Endovascular Surgery, Cardiovascular, Department, University Hospital of Trieste ASUGI, Trieste, Italy.
  • Kölbel T; Vascular Surgery, DIMES-University of Bologna, IRCCS-University Hospital Policlinico S. Orsola, Bologna, Italy.
  • Lindström D; Division of Vascular Surgery, "Vita-Salute" San Raffaele University, IRCCS San Raffaele Institute, Milano, Italy.
  • Dias N; German Aortic Center, Department of Vascular Medicine, University Hospital Eppendorf, Hamburg, Germany.
  • Lundberg G; Section of Vascular Surgery, Department of Surgical Sciences, University of Uppsala, Uppsala, Sweden.
  • Böckler D; Department of Thoracic Surgery and Vascular Diseases, Vascular Center Malmö, Skåne University Hospital and Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
  • Parlani G; Department of Vascular Surgery, Karolinska University Hospital, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
  • Antonello M; Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Heidelberg, Germany.
  • Veraldi GF; Unit of Vascular and Endovascular Surgery, Hospital S.M. Misericordia, University of Perugia, Perugia, Italy.
  • Tsilimparis N; Vascular and Endovascular Surgery Section, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
  • Kotelis D; Department of Vascular Surgery, University Hospital and Trust of Verona, Verona, Italy.
  • Dueppers P; Department of Vascular Surgery, Ludwig Maximilian University Hospital, Munich, Germany.
  • Tinelli G; Department of Vascular Surgery, University Hospital RWTH Aachen, Aachen, Germany.
  • Ippoliti A; Department of Vascular Surgery, Bern University Hospital, Bern, Switzerland.
  • Spath P; Department of Vascular Surgery, Zurich University Hospital, Zurich, Switzerland.
  • Logiacco A; Unit of Vascular Surgery, Fondazione Policlinico Universitario Gemelli IRCCS-Universita Cattolica del Sacro Cuore, Rome, Italy.
  • Schurink GWH; Vascular Surgery Unit, Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy.
  • Chiesa R; Vascular Surgery, DIMES-University of Bologna, IRCCS-University Hospital Policlinico S. Orsola, Bologna, Italy.
  • Grandi A; Vascular Surgery, DIMES-University of Bologna, IRCCS-University Hospital Policlinico S. Orsola, Bologna, Italy.
  • Panuccio G; Division of Vascular Surgery, Maastricht Heart and Vascular Center, Maastricht, The Netherlands.
  • Rohlffs F; Division of Vascular Surgery, "Vita-Salute" San Raffaele University, IRCCS San Raffaele Institute, Milano, Italy.
  • Wanhainen A; Division of Vascular Surgery, "Vita-Salute" San Raffaele University, IRCCS San Raffaele Institute, Milano, Italy.
  • Mani K; German Aortic Center, Department of Vascular Medicine, University Hospital Eppendorf, Hamburg, Germany.
  • Karelis A; German Aortic Center, Department of Vascular Medicine, University Hospital Eppendorf, Hamburg, Germany.
  • Sonesson B; Section of Vascular Surgery, Department of Surgical Sciences, University of Uppsala, Uppsala, Sweden.
  • Jonsson M; Section of Vascular Surgery, Department of Surgical Sciences, University of Uppsala, Uppsala, Sweden.
  • Bresler AM; Department of Thoracic Surgery and Vascular Diseases, Vascular Center Malmö, Skåne University Hospital and Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
  • Simonte G; Department of Thoracic Surgery and Vascular Diseases, Vascular Center Malmö, Skåne University Hospital and Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
  • Isernia G; Department of Vascular Surgery, Karolinska University Hospital, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
  • Xodo A; Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Heidelberg, Germany.
  • Mezzetto L; Unit of Vascular and Endovascular Surgery, Hospital S.M. Misericordia, University of Perugia, Perugia, Italy.
  • Mastrorilli D; Unit of Vascular and Endovascular Surgery, Hospital S.M. Misericordia, University of Perugia, Perugia, Italy.
  • Prendes CF; Vascular and Endovascular Surgery Section, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
  • Chaikhouni B; Department of Vascular Surgery, University Hospital and Trust of Verona, Verona, Italy.
  • Zimmermann A; Department of Vascular Surgery, University Hospital and Trust of Verona, Verona, Italy.
  • Lepidi S; Department of Vascular Surgery, Ludwig Maximilian University Hospital, Munich, Germany.
  • Gargiulo M; Department of Vascular Surgery, University Hospital RWTH Aachen, Aachen, Germany.
  • Mees B; Department of Vascular Surgery, Bern University Hospital, Bern, Switzerland.
  • Unosson J; Department of Vascular Surgery, Zurich University Hospital, Zurich, Switzerland.
Ann Surg ; 278(2): e389-e395, 2023 08 01.
Article en En | MEDLINE | ID: mdl-35837956
ABSTRACT

OBJECTIVE:

To report the mid-term outcomes of fenestrated-branched endovascular aneurysm repair (F-BEVAR) following a failed previous endovascular aneurysm repair (pEVAR) or previous open aneurysm repair (pOAR).

METHODS:

Data from consecutive patients who underwent F-BEVAR for pEVAR or pOAR from 2006 to 2021 from 17 European vascular centers were analyzed. Endpoints included technical success, major adverse events, 30-day mortality, and 5-year estimates of survival, target vessel primary patency, freedom from reinterventions, type I/III endoleaks, and sac growth >5 mm.

BACKGROUND:

Treatment of a failed previous abdominal aortic aneurysm repair is a complex undertaking. F-BEVAR is becoming an increasingly attractive option, although comparative data are limited regarding associated risk factors, indications for treatment, and various outcomes.

RESULTS:

There were 526 patients included, 268 pOAR and 258 pEVAR. The median time from previous repair to F-BEVAR was 7 (interquartile range, 4-12) years, 5 (3-8) for pEVAR, and 10 (6-14) for pOAR, P <0.001. Predominant indication for treatment was type Ia endoleak for pEVAR and progression of the disease for pOAR. Technical success was 92.8%, pOAR (92.2%), and pEVAR (93.4%), P =0.58. The 30-day mortality was 6.5% overall, 6.7% for pOAR, and 6.2% for pEVAR, P =0.81. There were 1853 treated target vessels with 5-year estimates of primary patency of 94.4%, pEVAR (95.2%), and pOAR (94.4%), P =0.03. Five-year estimates for freedom from type I/III endoleaks were similar between groups; freedom from reintervention was lower for pEVAR (38.3%) than for pOAR (56.0%), P =0.004. The most common indication for reinterventions was for type I/III endoleaks (37.5%).

CONCLUSIONS:

Repair of a failed pEVAR or pOARis safe and feasible with comparable technical success and survival rates. While successful treatment can be achieved, significant rates of reintervention should be anticipated, particularly for issues related to instability of target vessels/bridging stents.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aneurisma de la Aorta Abdominal / Implantación de Prótesis Vascular / Procedimientos Endovasculares Tipo de estudio: Risk_factors_studies Límite: Humans Idioma: En Revista: Ann Surg Año: 2023 Tipo del documento: Article País de afiliación: Suecia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aneurisma de la Aorta Abdominal / Implantación de Prótesis Vascular / Procedimientos Endovasculares Tipo de estudio: Risk_factors_studies Límite: Humans Idioma: En Revista: Ann Surg Año: 2023 Tipo del documento: Article País de afiliación: Suecia