Comparing mobile C-arm to a hybrid operating room for imaging in fenestrated stent-graft endovascular abdominal aortic aneurysm repair.

PURPOSE: To evaluate the advantages of a hybrid operating room (group two) compared to a fluoroscopic mobile C-arm (group one) during fenestrated stent-graft endovascular aneurysm repair (f-EVAR). MATERIALS AND METHODS: This single center study retrospectively analysed prospectively collected data of consecutive patients treated with f-EVAR for short-neck, juxta-, suprarenal aortic aneurysms between January 2006 and July 2016. Primary endpoints were technical success and perioperative complications. Secondary endpoints included 30-day and one-year mortality, and target vessel patency. RESULTS: 96 patients were treated (85 men, 74.1 +/- 6.3 years), 46 patients (48%) patients belonging to group one and 50 (52%) patients to group two. Technical success was achieved in 92.7% of the procedures (group one 91.3% vs. group two 94%, p=0.72). Significantly more complex interventions were performed in group two (n=38/50) compared to group one (n=14/46; p<0.001), in which primarily renal f-EVAR interventions were performed. In group two significantly less contrast was used (median 150 mL versus 100 mL; p<0.001). The 30-day mortality in group one was 9% and 2% in group two (p=0.14), and one-year survival was also not significantly different between both groups. Target visceral vessel primary patency was significantly higher in group one (87.6% versus 85.5% (p=0.006) and 83.8% versus 78.3% (p=0.03) at 6 and 12 months respectively). There was no significant difference in renal artery primary patency at 6 and 12 months. CONCLUSION: Immediate and one-year outcomes following f-EVAR for AAA were comparable using a hybrid operating room compared to a mobile C-arm, despite the use of significantly more complex stent-grafts in the patients treated in the hybrid OR. The use of a hybrid OR may assist in achieving satisfying results in complex f-EVAR.