Fenestrated Stent Grafting for Short-necked and
Juxtarenal Abdominal Aortic Aneurysm: An 8-Year
Single-centre Experience
E.L.G. Verhoeven , G Vourliotakis, Bos WT, Tielliu IF, Zeebregts CJ, Prins TR, Bracale UM, van den Dungen JJ.
Juxtarenal Abdominal Aortic Aneurysm: An 8-Year
Single-centre Experience
E.L.G. Verhoeven , G Vourliotakis, Bos WT, Tielliu IF, Zeebregts CJ, Prins TR, Bracale UM, van den Dungen JJ.
Department of Surgery (Division of Vascular Surgery), University Medical Center Groningen, Groningen, The Netherlands
Abdominal aortic aneurysm
Abstract Objectives: To present an 8-year clinical experience in the endovascular treatment
of short-necked and juxtarenal abdominal aortic aneurysm (AAA) with fenestrated stent grafts.
Methods: At our tertiary referral centre, all patients treated with fenestrated and branched
stent grafts have been enrolled in an investigational device protocol database. Patients with
short-necked or juxtarenal AAA managed with fenestrated endovascular aneurysm repair
(F-EVAR) between November 2001 and April 2009 were retrospectively reviewed. Patients
treated at other hospitals under the supervision of the main author were excluded from the
study. Patients treated for suprarenal or thoraco-abdominal aneurysms were also excluded.
All stent grafts used were customised based on the Zenith system. Indications for repair, operative
and postoperative mortality and morbidity were evaluated. Differences between groups
were determined using analysis of variance with P < 0.05 considered significant.
Results: One hundred patients (87 males/13 females) with a median age of 73 years (range,
50e91 years) were treated during the study period; this included 16 patients after previous
open surgery or EVAR. Thirty-day mortality was 1%. Intra-operative conversion to open repair
was needed in one patient. Operative visceral vessel perfusion rate was 98.9% (272/275).
Median follow-up was 24 months (range, 1e87 months). Twenty-two patients died during
follow-up, all aneurysm unrelated. No aneurysm ruptured. Estimated survival rates at 1,
2 and 5 years were 90.3 3.1%, 84.4 4.0% and 58.5 8.1%, respectively. Cumulative visceral
branch patency was 93.3 1.9% at 5 years. Visceral artery stent occlusions all occurred within
the first 2 postoperative years. Four renal artery stent fractures were observed, of which three
were associated with occlusion. Twenty-five patients had an increase of serum creatinine of
Eur J Vasc Endovasc Surg (2010) 39, 529e536
Abdominal aortic aneurysm
Abstract Objectives: To present an 8-year clinical experience in the endovascular treatment
of short-necked and juxtarenal abdominal aortic aneurysm (AAA) with fenestrated stent grafts.
Methods: At our tertiary referral centre, all patients treated with fenestrated and branched
stent grafts have been enrolled in an investigational device protocol database. Patients with
short-necked or juxtarenal AAA managed with fenestrated endovascular aneurysm repair
(F-EVAR) between November 2001 and April 2009 were retrospectively reviewed. Patients
treated at other hospitals under the supervision of the main author were excluded from the
study. Patients treated for suprarenal or thoraco-abdominal aneurysms were also excluded.
All stent grafts used were customised based on the Zenith system. Indications for repair, operative
and postoperative mortality and morbidity were evaluated. Differences between groups
were determined using analysis of variance with P < 0.05 considered significant.
Results: One hundred patients (87 males/13 females) with a median age of 73 years (range,
50e91 years) were treated during the study period; this included 16 patients after previous
open surgery or EVAR. Thirty-day mortality was 1%. Intra-operative conversion to open repair
was needed in one patient. Operative visceral vessel perfusion rate was 98.9% (272/275).
Median follow-up was 24 months (range, 1e87 months). Twenty-two patients died during
follow-up, all aneurysm unrelated. No aneurysm ruptured. Estimated survival rates at 1,
2 and 5 years were 90.3 3.1%, 84.4 4.0% and 58.5 8.1%, respectively. Cumulative visceral
branch patency was 93.3 1.9% at 5 years. Visceral artery stent occlusions all occurred within
the first 2 postoperative years. Four renal artery stent fractures were observed, of which three
were associated with occlusion. Twenty-five patients had an increase of serum creatinine of
Eur J Vasc Endovasc Surg (2010) 39, 529e536
