Short-term outcomes of inner branches for endovascular repair of complex abdominal and thoracoabdominal aortic aneurysms

Daniel Silverberg, Avner Bar-Dayan, Haitam Hater, Boris Khaitovich, Moshe Halak

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To report our early experience using endografts with inner branches for the treatment of complex abdominal aortic aneurysms and thoracoabdominal aortic aneurysms (TAAAs). Methods: A retrospective analysis of all patients treated in our institution for complex abdominal aortic aneurysms and TAAAs with custom-made stent grafts consisting of one or more inner branches. Data collected included patients demographics, aortic aneurysm morphology, stent grafts features, perioperative morbidity and mortality and short-term reintervention and mortality rates. Results: Twenty-seven patients (18 males, mean age 70 ± 7.1) were included. Indications for surgery included TAAAs (12, 41%) juxtarenal abdominal aortic aneurysms (10, 37%), type 1A endoleaks (4, 15%) and paraanastamotic aneurysms (1, 4%). A total of 90 inner branches were used. Twenty-one (78%) of the stent grafts consisted only of inner branches and six (22%) had a combination of inner branches with either fenestrations or outer branches. Technical success was achieved in 26/27 (96%) of the patients. There was one perioperative mortality. Six patients suffered from major perioperative adverse events. Mean follow-up was seven months (range 1–23). During the follow-up period, four patients (15%) required reinterventions. Branch-related reinterventions were performed in two (7%) patients. No occlusions of inner branches occurred during the follow-up. Conclusions: Inner branches in branched endovascular aneurysm repairs offer a feasible option for the treatment of complex abdominal aortic aneurysms and TAAAs. The procedures can be completed with high technical success and with acceptable short-term branch-related reintervention rates. Further follow-up is required to determine the long-term durability of this technology.

Original languageEnglish
Pages (from-to)644-651
Number of pages8
JournalVascular
Volume29
Issue number5
DOIs
StatePublished - Oct 2021

Keywords

  • BEVAR
  • FEVAR
  • Inner branches
  • aneurysm
  • complex aneurysm
  • thoracoabdominal aortic aneurysm

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