A propensity-matched comparison of fenestrated endovascular aneurysm repair and open surgical repair of pararenal and paravisceral aortic aneurysms

Giovanni Tinelli, Maria Antonietta Crea, Chiara de Waure, Gian Luca Di Tanna, Jean-Pierre Becquemin, Jonathan Sobocinski, Francesco Snider, Stéphan Haulon
  • Journal of Vascular Surgery, September 2018, Elsevier
  • DOI: 10.1016/j.jvs.2017.12.060

FEVAR vs open surgery for pararenal aortic aneurysm, a propensity-matched comparison.

What is it about?

Similar outcomes after fenestrated and branched endovascular aneurysm repair or OSR for pararenal and paravisceral aortic aneurysms. No difference in 30-day mortality or postoperative complications between groups with the exception of acute kidney injury, which was more frequent after OSR, although most patients recovered before discharge.

Why is it important?

This study considers the results of two high-volume centers without a learning curve bias with a 1:1 propensity matching in 204 patients. These data indicate that the endovascular group, at “high risk” for open repair, includes a high-risk subgroup for endovascular procedures because of atherothrombotic parietal disease in the descending and visceral aorta.

Perspectives

MD, PhD Giovanni Tinelli
Gemelli Foundation Catholic University of Rome

We believe that high-volume aortic centers that perform both open and endovascular repairs and that have decades of experience, as well as a team approach that uses dedicated protocols, are key in achieving excel- lent early and midterm outcomes. In addition, in a center that is performing both techniques, high-risk patients can be offered a complex endovascular repair with clear information about the death and dialysis risks.

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http://dx.doi.org/10.1016/j.jvs.2017.12.060

The following have contributed to this page: MD, PhD Giovanni Tinelli