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Home > Press Center > Branched and Fenestrated Endografts

Contact:
Jill Goodwin
Director of Communications
312-334-2308

Endovascular aneurysm repair (EVAR) has become an effective method of minimally invasive surgery which provides for improved outcomes, shorter hospital stay, less morbidity and quicker return to activity. However, some patients with unfavorable anatomy (e.g. those with shorter aortic necks or highly angulated necks) are not suitable candidates for this procedure.

At the 60th Annual Meeting of the Society for Vascular Surgery, research from The Netherlands examined the use of branched and fenestrated (window-like openings) endografts for patients who had complex aortic aneurysms in a mid-term study. It was presented by Bart Muhs, of Groningen University Medical Center, Groningen, The Netherlands.

“Thirty-eight patients who did not qualify for traditional EVAR and had aortic abdominal aneurysms of more that 5.5cm were studied, said Dr. Muhs. “Customized stent grafts were either fenestrated or branched, and based on the Zenith system.”

Dr. Muhs added that cumulative branch patency was 92 percent at 46 months. In the first year only, aneurysm sac decreased and during the same time period stent occlusions all occurred in unstented fenestrations or scallops. No occlusions occurred in stented vessels.   

Angiography confirmed successful sealing in 37 patients and an operative visceral vessel perfusion rate was 94 percent. However, after a mean 25.8 months follow-up, five died; at 30 days mortality was 2.6 percent.  

"With a follow-up of more than two years our study shows that fenestrated and branched techniques have had excellent technical success and promising mid-term results,” said Dr. Muhs. "However, there still are some concerns such as late visceral vessels stenosis, endoleaks and permanent renal impairment. Failures were small and occurred primarily during the first year. According to study measures they included death, secondary interventions, branch vessel patency and complications. However, complications stabilize in longer-term
follow-up.”

We believe that longer-term results are needed, including randomized clinical trials to determine safety, efficacy and stability of this system,” said Dr. Muhs.