TY - JOUR
T1 - Feasibility and Twelve-month Patency of a Six-fold Fenestrated Stent Graft for Type IV Thoracoabdominal Aneurysm Repair
AU - Kalder, Johannes
AU - Gombert, Alexander
AU - Kotelis, Drosos
AU - Jacobs, Michael J.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Background: Fenestrated endovascular aortic aneurysm repair (FEVAR) is a standard procedure for the treatment of complex aortic aneurysm. More than 4 fenestrations are still randomly used, even in case of complex aneurysm anatomy involving accessory renal arteries. Methods: We are presenting the case of a 62-year-old male patient suffering from 63-mm juxtarenal aortic aneurysm. Because of his medical history and an ongoing immunosuppressive medication an endovascular approach was conducted. Using a 6-fold fenestrated endograft, 4 renal arteries as well as the superior mesenteric artery and the celiac trunk have been cannulated and stented successfully. Results: No perioperative complications such as impairment of renal function could be observed. After 12 months, still a nonhampered renal function could be assessed. Furthermore, the endoprosthesis showed a good fit without detection of endoleaks, patent fenestrations, and a decreasing aneurysm diameter after 12 months of follow-up. Coverage of accessory renal arteries has been described as an established and necessary technique during endovascular repair of juxtarenal aortic aneurysm; yet coverage of these vessels may be related to renal infarction and an impaired renal function during follow-up. Based on current technical developments the implantation of a 6-fold FEVAR may be conducted with promising results. Conclusions: Six-fold fenestrated stent-graft prosthesis for the treatment of juxtarenal aortic aneurysm involving accessory renal arteries may be a feasible treatment option related to an appropriate 12-month patency.
AB - Background: Fenestrated endovascular aortic aneurysm repair (FEVAR) is a standard procedure for the treatment of complex aortic aneurysm. More than 4 fenestrations are still randomly used, even in case of complex aneurysm anatomy involving accessory renal arteries. Methods: We are presenting the case of a 62-year-old male patient suffering from 63-mm juxtarenal aortic aneurysm. Because of his medical history and an ongoing immunosuppressive medication an endovascular approach was conducted. Using a 6-fold fenestrated endograft, 4 renal arteries as well as the superior mesenteric artery and the celiac trunk have been cannulated and stented successfully. Results: No perioperative complications such as impairment of renal function could be observed. After 12 months, still a nonhampered renal function could be assessed. Furthermore, the endoprosthesis showed a good fit without detection of endoleaks, patent fenestrations, and a decreasing aneurysm diameter after 12 months of follow-up. Coverage of accessory renal arteries has been described as an established and necessary technique during endovascular repair of juxtarenal aortic aneurysm; yet coverage of these vessels may be related to renal infarction and an impaired renal function during follow-up. Based on current technical developments the implantation of a 6-fold FEVAR may be conducted with promising results. Conclusions: Six-fold fenestrated stent-graft prosthesis for the treatment of juxtarenal aortic aneurysm involving accessory renal arteries may be a feasible treatment option related to an appropriate 12-month patency.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85068443572&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31195107
U2 - https://doi.org/10.1016/j.avsg.2019.03.004
DO - https://doi.org/10.1016/j.avsg.2019.03.004
M3 - Article
C2 - 31195107
SN - 0890-5096
VL - 60
SP - 478.e1-478.e5
JO - Annals of Vascular Surgery
JF - Annals of Vascular Surgery
ER -