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European Multicentric Experience with Fenestrated-Branched ENDOvascular Stent-grafting after Previous FAILed Infrarenal Aortic Repair : the EU-FBENDO-FAIL Registry

Budtz-Lilly, Jacob ; D'Oria, Mario ; Gallitto, Enrico ; Bertoglio, Luca ; Kölbel, Tilo LU ; Lindström, David ; Dias, Nuno LU orcid ; Lundberg, Goran ; Böckler, Dittmar and Parlani, Gianbattista , et al. (2023) In Annals of Surgery 278(2). p.389-395
Abstract

OBJECTIVE: To report the mid-term outcomes of fenestrated-branched endovascular aneurysm repair (F-BEVAR) following a failed previous endovascular aneurysm repair (pEVAR) or previous open aneurysm repair (pOAR).

METHODS: Data from consecutive patients who underwent F-BEVAR for pEVAR or pOAR from 2006-2021 from 17 European vascular centres were analyzed. Endpoints included technical success, major adverse events (MAE), 30-day mortality, and 5-year estimates of survival, target vessel primary patency, freedom from reinterventions, type I/III endoleaks, and sac growth >5 mm.

SUMMARY BACKGROUND DATA: Treatment of a failed previous abdominal aortic aneurysm (AAA) repair is a complex undertaking. F-BEVAR is becoming an... (More)

OBJECTIVE: To report the mid-term outcomes of fenestrated-branched endovascular aneurysm repair (F-BEVAR) following a failed previous endovascular aneurysm repair (pEVAR) or previous open aneurysm repair (pOAR).

METHODS: Data from consecutive patients who underwent F-BEVAR for pEVAR or pOAR from 2006-2021 from 17 European vascular centres were analyzed. Endpoints included technical success, major adverse events (MAE), 30-day mortality, and 5-year estimates of survival, target vessel primary patency, freedom from reinterventions, type I/III endoleaks, and sac growth >5 mm.

SUMMARY BACKGROUND DATA: Treatment of a failed previous abdominal aortic aneurysm (AAA) repair is a complex undertaking. F-BEVAR is becoming an increasingly attractive option, although comparative data are limited regarding associated risk factors, indications for treatment, and various outcomes.

RESULTS: There were 526 patients included, 268 pOAR and 258 pEVAR. Median time from previous repair to F-BEVAR was 7 (IQR, 4-12) years, 5 (3-8) for pEVAR and 10 (6-14) for pOAR, P<0.001. Predominant indication for treatment was Type Ia endoleak for pEVAR and progression of disease for pOAR. Technical success was 92.8%, pOAR (92.2%) and pEVAR (93.4%), P=0.58. The 30-day mortality was 6.5% overall, 6.7% for pOAR and 6.2% for pEVAR, P=0.81. There were 1853 treated target vessels with 5-year estimates of primary patency of 94.4%, pEVAR (95.2%) and pOAR (94.4%), P=0.03. Five-year estimates for freedom from type I/III endoleaks were similar between groups; freedom from reintervention was lower for pEVAR (38.3%) than for pOAR (56.0%), P=0.004 The most common indication for reinterventions was for type I/III endoleaks (37.5%).

CONCLUSIONS: Repair of a failed previous EVAR or OAR is safe and feasible with comparable technical success and survival rates. While successful treatment can be achieved, significant rates of reintervention should be anticipated, particularly for issues related to instability of target vessels/bridging stents.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Surgery
volume
278
issue
2
pages
389 - 395
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:35837956
  • scopus:85151381222
ISSN
1528-1140
DOI
10.1097/SLA.0000000000005577
language
English
LU publication?
yes
additional info
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
id
172c8726-5c13-42f9-9f3f-582d70b3fdad
date added to LUP
2022-10-03 07:30:27
date last changed
2024-12-14 20:57:21
@article{172c8726-5c13-42f9-9f3f-582d70b3fdad,
  abstract     = {{<p>OBJECTIVE: To report the mid-term outcomes of fenestrated-branched endovascular aneurysm repair (F-BEVAR) following a failed previous endovascular aneurysm repair (pEVAR) or previous open aneurysm repair (pOAR).</p><p>METHODS: Data from consecutive patients who underwent F-BEVAR for pEVAR or pOAR from 2006-2021 from 17 European vascular centres were analyzed. Endpoints included technical success, major adverse events (MAE), 30-day mortality, and 5-year estimates of survival, target vessel primary patency, freedom from reinterventions, type I/III endoleaks, and sac growth &gt;5 mm.</p><p>SUMMARY BACKGROUND DATA: Treatment of a failed previous abdominal aortic aneurysm (AAA) repair is a complex undertaking. F-BEVAR is becoming an increasingly attractive option, although comparative data are limited regarding associated risk factors, indications for treatment, and various outcomes.</p><p>RESULTS: There were 526 patients included, 268 pOAR and 258 pEVAR. Median time from previous repair to F-BEVAR was 7 (IQR, 4-12) years, 5 (3-8) for pEVAR and 10 (6-14) for pOAR, P&lt;0.001. Predominant indication for treatment was Type Ia endoleak for pEVAR and progression of disease for pOAR. Technical success was 92.8%, pOAR (92.2%) and pEVAR (93.4%), P=0.58. The 30-day mortality was 6.5% overall, 6.7% for pOAR and 6.2% for pEVAR, P=0.81. There were 1853 treated target vessels with 5-year estimates of primary patency of 94.4%, pEVAR (95.2%) and pOAR (94.4%), P=0.03. Five-year estimates for freedom from type I/III endoleaks were similar between groups; freedom from reintervention was lower for pEVAR (38.3%) than for pOAR (56.0%), P=0.004 The most common indication for reinterventions was for type I/III endoleaks (37.5%).</p><p>CONCLUSIONS: Repair of a failed previous EVAR or OAR is safe and feasible with comparable technical success and survival rates. While successful treatment can be achieved, significant rates of reintervention should be anticipated, particularly for issues related to instability of target vessels/bridging stents.</p>}},
  author       = {{Budtz-Lilly, Jacob and D'Oria, Mario and Gallitto, Enrico and Bertoglio, Luca and Kölbel, Tilo and Lindström, David and Dias, Nuno and Lundberg, Goran and Böckler, Dittmar and Parlani, Gianbattista and Antonello, Michele and Veraldi, Gian Franco and Tsilimparis, Nikolaos and Kotelis, Drosos and Dueppers, Philip and Tinelli, Giovanni and Ippoliti, Arnaldo and Spath, Paolo and Logiacco, Antonino and Schurink, Geert Willem H and Chiesa, Roberto and Grandi, Alessandro and Panuccio, Giuseppe and Rohlffs, Fiona and Wanhainen, Anders and Mani, Kevin and Karelis, Angelos and Sonesson, Björn and Jonsson, Magnus and Bresler, Alina-Marilena and Simonte, Gioele and Isernia, Giacomo and Xodo, Andrea and Mezzetto, Luca and Mastrorilli, Davide and Prendes, Carlota Fernandez and Chaikouni, Basel and Zimmermann, Alexander and Lepidi, Sandro and Gargiulo, Mauro and Mees, Barend and Unosson, Jon}},
  issn         = {{1528-1140}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{389--395}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Annals of Surgery}},
  title        = {{European Multicentric Experience with Fenestrated-Branched ENDOvascular Stent-grafting after Previous FAILed Infrarenal Aortic Repair : the EU-FBENDO-FAIL Registry}},
  url          = {{http://dx.doi.org/10.1097/SLA.0000000000005577}},
  doi          = {{10.1097/SLA.0000000000005577}},
  volume       = {{278}},
  year         = {{2023}},
}