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.

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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

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.

MD, PhD Giovanni Tinelli
Gemelli Foundation Catholic University of Rome

Read the Original

This page is a summary of: A propensity-matched comparison of fenestrated endovascular aneurysm repair and open surgical repair of pararenal and paravisceral aortic aneurysms, Journal of Vascular Surgery, September 2018, Elsevier,
DOI: 10.1016/j.jvs.2017.12.060.
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