Five Year Results of Off the Shelf Fenestrated Endografts for Elective and Emergency Repair of Juxtarenal Abdominal Aortic Aneurysm

ObjectiveFenestrated endovascular aneurysm repair (FEVAR) is a well established treatment for complex abdominal aortic aneurysms (AAAs). FEVAR with custom made devices (CMDs) has limitations in both the emergency and elective settings due to time consuming manufacture. “Off shelf” (OTS) fenestrated stent grafts are potential solution. The primary goal was evaluate five year outcome of COOK Zenith p-Branch OTS device at single centre.MethodsPatients juxtarenal AAA meeting inclusion criteria were enrolled prospective, non-randomised, non-comparative trial from July 2012 September 2015. Demographic, anatomical, procedure related, follow up data collected, analysed, adjudicated by core laboratory. aims assess intervention free survival overall years.ResultsTwenty-three patients treated 21 completed up. Mean implantation after patient presentation 28 hours (range 0–122 hours) cases 67 days 20–112 days) cases. Median 283 minutes 161–475 minutes) technical success 91%. 45 months (standard deviation ± 24.4 months). most common adverse events renal injuries. Primary target vessel patency 96.4% 94.0% one years respectively. first re-intervention 469 0–1 567 days). Survival during period 76%, no related deaths.ConclusionFEVAR safe effective selected population, settings. Long term outcomes acceptable although inferior CMDs. Mid long emphasise as possible pathology where CMD not an option. Further innovation address complications needed, these seem more prevalent than Fenestrated centre. Patients years. Twenty-three deaths.