Fenestrated endovascular aortic repair grafts

Endovascular repair of AAAs has been embraced by the vascular surgery community. Fenestrated endovascular repair of AAAs is the logical next step to repairing those aneurysms whose anatomy does not provide a secure landing area for the graft below the renal and other visceral vessels. While the early morbidity and mortality reported with endovascular repair is less than with open procedures, additional monitoring and endovascular interventions are necessary with EVAR. Those same issues are presumed to persist with interventions utilizing f-EVAR, along with the additional concern for end-organ ischemia. In addition to fenestrated grafts, grafts with scallop, "chimney," and side branch configurations are being developed. PAs need to keep abreast of developments and understand the benefits and concerns associated with these applications in order to guide and monitor patients whose conditions are suitable for these emerging interventions.