Impact of number of vessels targeted on outcomes of fenestrated-branched endovascular repair for complex abdominal aortic aneurysms.

Abstract Purpose The aim of this study was to investigate the impact of number of vessels targeted by fenestrations or branches on early outcomes of fenestrated – branched endovascular aortic repair (F-BEVAR) for complex abdominal aortic aneurysms (cAAAs). Methods The clinical data of 260 patients (209 male; mean, 74±7 years) treated for cAAAs in four academic centers using fenestrated-branched stent-grafts with one to five fenestrations or branches was entered into prospectively maintained databases (2010-2015). Data was analyzed in patients treated with ≤2-vessel (Group 1, n=124), 3-vessel (Group 2, n=80) or ≥4 fenestrations or directional branches (Group 3, n=56). For group definition, only vessels incorporated by fenestrations or directional branches were accounted. End-points were technical success, procedural variables, 30-day mortality and major adverse events (MAEs). Results A total of 830 vessels (mean, 3.19±0.8 vessels/patient) were targeted by fenestrations (n=672), scallops (n=136) or branches (n=22). Two-vessel designs were used more often in the early experience (64%), whereas ≥3-vessel design (groups 2 and 3) was preferred in the late experience (68%, p .05). Conclusion F-BEVAR for complex abdominal aortic aneurysms was associated with high technical success, low 30-day mortality and morbidity. Increasing complexity was associated with longer operating and fluoroscopy time, more contrast use, and longer hospital stay, but did not affect technical success and MAEs of the procedure.