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Updated: May 19, 2026
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A New Murine Model of Endovascular Aortic Aneurysm Repair
Published on: July 7, 2013
Fenestrated endovascular aneurysm repair: graft complexity does not predict outcome
Matt J Metcalfe1, Peter J Holt, Robert J Hinchliffe
1St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK. mmetcalfe@doctors.org.uk
Summary
For pararenal aortic aneurysms, complex endografts including mesenteric arteries showed similar outcomes to simpler renal-only fenestrated EVAR (endovascular aneurysm repair). Careful patient selection is key for successful fenestrated EVAR.
Area of Science:
- Vascular Surgery
- Endovascular Repair
- Aortic Aneurysm Treatment
Background:
- Pararenal aortic aneurysms pose complex challenges for endovascular aneurysm repair (EVAR).
- Fenestrated endografts are crucial for preserving visceral and renal arteries during EVAR.
- Comparing graft designs is essential for optimizing patient outcomes.
Purpose of the Study:
- To compare outcomes of fenestrated EVAR using grafts with renal arteries alone versus those incorporating mesenteric arteries.
- To evaluate the safety and efficacy of complex fenestrated EVAR designs in treating pararenal aortic aneurysms.
Main Methods:
- Retrospective analysis of 42 patients undergoing fenestrated EVAR for pararenal, suprarenal, or juxtarenal aortic aneurysms.
- Comparison of outcomes between complex fenestrated EVAR (n=17) and renal-only fenestrated EVAR (n=25).
- Major morbidity/mortality included death, myocardial infarction, renal failure, paraplegia, and bowel ischemia.
Main Results:
- Successful target vessel cannulation and stenting in 98% of cases.
- 30-day outcomes: 7% mortality, 2% paraplegia, 5% myocardial infarction.
- Complex fenestrated EVAR showed a trend towards higher major morbidity/mortality (24% vs. 8%), but this was not statistically significant (p=0.20).
Conclusions:
- In selected patients, incorporating mesenteric arteries into fenestrated EVAR designs did not significantly alter outcomes compared to renal-only fenestrated EVAR.
- The study suggests that both graft designs can be effective when applied judiciously.
- Further research may explore specific patient subgroups who benefit most from complex fenestrated EVAR designs.
