Endovascular treatment of thoracoabdominal aortic aneurysms using physician modified Ankura endo-grafts

Objective To evaluate the early results of preprocedural fenestrated technique of thoracoabdominal aortic aneurysms (TAAAs) using physician-modified Ankura endo-grafts (PMEGs) . Methods 29 consecutive patients who underwent fenestrated-branched endovascular aortic repair(F/B-EVAR) using PMEGs between January 2018 and December 2018 were retrospectively reviewed. The perioperative mortality and morbidity of the f/bEVAR techique was assessed and the early results of follow up were evaluated. Results The median age of patients was 65.3 years old (range,48-83 years) , and 24 patients (82.8%) were male. There were 11 cases of aortic aneurysm and 18 cases of post aortic dissection aneurysm. Initial technical success rate of vesical revascularization was 98.9% (90 of 91) . There were no in-hospital death or no peri-operative neurology complications. One patient had failed reconstruction of the left renal artery during operation (blood supply from the distal tear and reconstructed successfully after 3 months) . Procedure time averaged (260.2±66.3) min with a mean volume of blood loss (187.5±113.1) ml. The mean volume of contrast utilized was (151.2±20.5) ml. The mean fluoroscopy time was (56.3±16.6) min. The mean postoperative ICU stay was (2.3±1.2) days. The mean postoperative hospital stay was (6.8±5.3) days. Conclusions F/B-EVAR using PMEGs may be a viable alternative for high risk patients with TAAAs. Key words: Thoracoabdominal aortic aneurysm; Endovascular aortic repair; Fenestration; Branch