¤CLINICAL INVESTIGATION ¤ Secondary Procedures After Aortic Aneurysm Repair With Fenestrated and Branched Endografts

Purpose: To investigate the secondary procedures in patients with previous endovascular aortic repair by fenestrated or branched stent-grafts for aneurysms involving the renal and visceral vessels. Methods: Between January 2001 and May 2010, 107 consecutive high-risk patients (97 men; mean age 73 years, range 50–86) with aortic aneurysms involving the renal and visceral arteries were treated with endovascular techniques. A custom-made Zenith graft was used in all patients. All secondary graft-related procedures performed in the perioperative period and during follow-up were analyzed. Estimates of survival, freedom from migration/type I endoleak, and freedom from any device-related secondary procedures were assessed with Kaplan-Meier analyses. Results: The 30-daymortality ratewas 1.9%. During follow-up (mean 25months, range 1–94), 34 secondary procedures were performed in 28 (26.2%) patients for 6 (17.6%) limb graft stenoses/thromboses (5.6 % of 107 cases), 8 (23.5%) in-stent visceral vessel stenoses/ occlusions (7.5 % of 107 cases), 8 (23.5%) migrations/type I endoleaks with/without visceral stent fractures (7.5 % of 107 cases), and 12 (35.3%) type III endoleaks (9.3 % of 107 cases). Th