Endovascular Repair of Complex Aortic Aneurysms

Area of Science:

• Vascular Surgery
• Endovascular Interventions
• Aortic Aneurysm Treatment

Background:

• Fenestrated-branched endovascular aortic repair (FB-EVAR) has become a standard treatment for complex aortic aneurysms.
• It is increasingly used as a first-line therapy, regardless of patient risk, for those with suitable anatomy.
• Available devices are off-the-shelf or patient-specific, with fenestrated, branched, or combined designs.

Purpose of the Study:

• To review recent advancements in endovascular repair for complex aortic aneurysms.
• To explore key aspects including treatment indications, preoperative assessment, patient selection criteria, device innovations, and implantation procedures.

Main Methods:

• Review of single and multicenter experiences.
• Analysis of systematic reviews comparing FB-EVAR with open surgical repair.
• Exploration of current literature on device design and implantation techniques.

Main Results:

• FB-EVAR demonstrates lower mortality and morbidity rates compared to historical open surgical repair outcomes.
• Significant advantages observed in reduced mortality, fewer respiratory complications, less acute kidney injury, and shorter hospital stays.
• Systematic reviews and multicenter experiences support the efficacy and safety of FB-EVAR.

Conclusions:

• FB-EVAR represents a significant advancement in managing complex aortic aneurysms.
• The technique offers improved patient outcomes regarding survival and complication rates.
• Continued evolution in device technology and surgical techniques further enhances FB-EVAR's role in aortic repair.