Parallel Stenting in Emergent Versus Nonemergent Complex Aortic Aneurysms

Complex aortic aneurysms such as juxtarenal, pararenal, and thoracoabdominal are a challenge to treat with open repair in patients significant comorbidities. Limited access fenestrated devices through clinical trials has led alternative endovascular approaches parallel stenting. The objective of this study was compare the outcomes these techniques when performed an emergent vs nonemergent setting. This single-institution retrospective review identified Current Procedural Terminology codes combining thoracic or aneurysm stenting for complex repairs from 2014 2021. were divided into two groups: repairs. Emergent defined ruptured aneurysms. Nonemergent included elective cases symptomatic, nonruptured primary end point mortality. secondary points perioperative complications length stay. Preoperative, intraoperative, postoperative factors compared between groups using bivariate logistic regression. A total 133 met inclusion criteria. Of patients, 20 (15%) group 113 (85%) group. Patients undergoing found have significantly higher mortality those (5 [25%] 5 [4.4%]; P = .001). These deaths occurred during index hospitalization. Those also rates renal failure requiring dialysis (3 13 [23.1%] 6 94 [6.4%]; .023). Sacrifice vessels owing nature surgery resulted difference. No differences gastrointestinal (11 [9.7%] 4 [20%]; .181) respiratory reintubation (6 [5.3%] 1 [5%]; .954). stay (11.6 ± 9.3 days 10.3 14.8 nonemergent; .766). Thoracic abdominal had acceptable However, continue be associated morbidity, often sacrifice resulting permanent dialysis. Careful patient selection preoperative discussion their family should considered high-risk patients.