This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Fenestrated endovascular repair for juxtarenal aortic aneurysm. BJS 2008; 95: 326-332.

Published: 11th October 2007

Authors: J. R. H. Scurr, J. A. Brennan, G. L. Gilling‐Smith, P. L. Harris, S. R. Vallabhaneni, R. G. McWilliams et al.

Background

The outcome of fenestrated endovascular aneurysm repair (F‐EVAR) was evaluated.

Method

Between February 2003 and December 2006, 45 patients (median age 73 (range 53–85) years) underwent primary (41) or secondary (four) F‐EVAR for an abdominal aortic aneurysm with infrarenal neck anatomy unsuitable for a standard stent‐graft. Median aneurysm diameter was 68 (range 55–100) mm and median infrarenal aortic neck length was 6 (range 0–13) mm. Customized fenestrated Zenith^® stent‐grafts were employed in all procedures, incorporating fenestrations to preserve flow into renal (80), superior mesenteric (35) and coeliac (two) arteries. Eighty‐two target vessels were stented (61 bare metal, 21 covered).

Results

All aneurysms were isolated successfully, with preservation of the target vessels. One accessory renal artery was lost. One patient died after 5 days from myocardial infarction, and another at 3 months from multiorgan failure secondary to atheroembolism. At median follow‐up of 24 (range 1–48) months, all aneurysms were stable or shrinking, with no late ruptures or graft‐related endoleaks. Six patients required a secondary intervention. The primary vessel patency rate was 96·6 per cent. There were four late deaths, unrelated to the aneurysm.

Conclusion

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