Fenestrated and branched endografts for the treatment of thoracoabdominal aortic aneurysms: a systematic review.

Journal Article (Review)

PURPOSE: To offer a critical review of the current literature on the use of fenestrated and branched stent-grafts in patients with thoracoabdominal aortic aneurysms (TAAA). METHODS: A thorough search of the English-language literature published between January 2000 and September 2009 identified reports of endovascular procedures using fenestrated and/or branched endografts as the intended repair strategy in patients with TAAA. Studies were selected based on specific inclusion criteria: (1) >3 high-risk patients with preoperative diagnosis of TAAA, (2) the intended treatment strategy was an endovascular repair using a fenestrated or branched endograft or both, and (3) patient demographics and outcome data (technical success rate, 30-day mortality, and follow-up length) were clearly stated. From 47 articles initially identified, 7 studies were included in the statistical analysis encompassing 155 patients (mean age 74.4 years, range 41-86) with TAAA averaging 69.2 mm in diameter. The mean follow-up was 11.8 months, and the majority of patients had Crawford type IV aneurysms. Outcome measures of eligible studies were tabulated and then analyzed cumulatively. RESULTS: Technical success was achieved in 94.2% (n = 146) of the 155 patients. Twenty-three (18.4%) primary endoleaks were reported. The 30-day mortality was 7.1% (n = 11), while the 1-year survival rate was 82.6% (n = 128). Three (1.9%) patients developed permanent paraplegia and 2 (1.3%) developed permanent paraparesis; renal failure was reported in 9 (5.8%). Overall follow-up mortality was 16.1% (n = 25). CONCLUSION: Endovascular treatment with fenestrated or/and branched stent-grafts is a new therapeutic option with encouraging results for patients considered unfit for conventional open repair. However, prolonged follow-up studies are needed in order to draw robust conclusions.

Full Text

Duke Authors

Cited Authors

  • Bakoyiannis, CN; Economopoulos, KP; Georgopoulos, S; Klonaris, C; Shialarou, M; Kafeza, M; Papalambros, E

Published Date

  • April 2010

Published In

Volume / Issue

  • 17 / 2

Start / End Page

  • 201 - 209

PubMed ID

  • 20426638

Electronic International Standard Serial Number (EISSN)

  • 1545-1550

International Standard Serial Number (ISSN)

  • 1526-6028

Digital Object Identifier (DOI)

  • 10.1583/09-2964.1

Language

  • eng