Supervisors info:
Γεώργιος Γερουλάκος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Αχιλλέας Χατζηιωάννου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Κακίσης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Aim: The aim of this study is to give a descriptive analysis that of the complication of fenestrated endovascular aortic repair for pararenal/juxtarenal abdominal aortic aneurysm occur intraoperative and postoperative.
Methods: An extensive electronic literature search was undertaken on account of identify all articles published from 1986 to May 2019 and described the 30-day mortality of fenestrated graft for pararena/juxtarenal abdominal aortic aneurysm repair. Overall, 522 studies evaluated where 496 studies of them were excluded due to the fact that they did not fulfill the study criteria. Finally, 26 studies took part in that include in total 2076 patients and 3785 were target vassels. Prospective and retrospective studies were included a well as case reports >10 patients.
Results: The average age of patients was 73.7 years,85.5% of patients were of male sex and the average of the aneurysm diameter was 61.2 cm. Where it comes to primary outcomes; 56 deaths reported within 30 day mortality 2,69%(0.0%-6.74%), technical success rate 96.45% (82,8%- 100%), 98.16%(94.29%-100%) primary target vessel patency rate, 0.95%(0.0%-2.23%) early stroke, 1.15%(0.0%-4.25%) spinal cord ischemia, 3.22%(0.0%-14.89%) cardiac, 3.55%(0.0%-11.90%) respiratory, 6.81%(0.0%-35.18%) acute renal injury, 6.52%(0.0%-25%) early reintervation, early endoleak type Ι 3.73%(0.0%-25.92), type ΙΙ 9.87%(0.0%-25.80) and type ΙΙΙ 1.06%(0.0%-5.55%). About the late outcomes, 94.56%(91.80%-97.1%) 12-months target vessel patency rate, 1.64%(0.0%-4.34%) permanent dialysis rate, 17.11%(0.0%-50.0%) late mortality, 16.17%(0.0%-57.40%) late reintervantion rate and late endoleaks type Ι 2.02%(0.0%-9.25%), type ΙΙ 8.72%(0.0%-26.6%) and type ΙΙΙ 1.03%(0.0%-6.89).
Conclusion: Endovascular repair with fenestrated stent-graft for pararenal/juxtarenal abdominal aortic aneurysms appears safe and effective as an alternative solution for open repair. So, for some patients, it is the only and valuable solution even is has high rate of reintervation. However, strict monitoring is required due to possible early and late complications. Finally, the endovascular repair of pararenal/juxtarenal aneurysm with fenestrated graft has good outcomes.
Keywords:
Fenestrated, Endovascular repair, Pararenal aneurysm, Juxtarenal aneurysm, Abdominal aortic aneurysm
