Ces radiol. 2024, 78(1):34-38 | DOI: 10.55095/CesRadiol2024/005

Patency of fenestrations after implantation of fenestrated and branched stent grafts in patients with pararenal abdominal aortic aneurysmOriginal article

Marie Černá^1,4, Petr Utíkal², Jana Zapletalová³, Vojtěch Prášil¹, Petr Dráč², Petr Kučera¹, Tomáš Maleňák¹, Pavel Jemelka¹, Tomáš Vávra¹, Martin Köcher¹

¹ Radiologická klinika LF UP a FN, Olomouc

² II. chirurgická klinika LF UP a FN, Olomouc

³ Ústav biofyziky, pracoviště biometrie LF UP, Olomouc

⁴ Fakulta zdravotnických odborov, Katedra medicínsko-technických odborov, UNIPO, Prešov

Aim: To evaluate the patency of fenestrations for the renal arteries, superiormesenteric artery, and truncus coeliacus in patients after implantation offenestrated and branched stent-grafts for pararenal abdominal aortic aneurysm.Another objective was to evaluate the incidence of late type Ia endoleak.

Methodology: In the period from 2002 to 2023, 87 patients with pararenalaneurysm of the abdominal aorta were treated at our institution with theimplantation of a fenestrated or branched stent-graft. There were 14 women and73 men aged from 51 to 86 years, the average age was 72 years. Sixty-ninepatients were followed-up a year or longer (1-13 years), with CT angiographyonce a year. Mean follow-up was 4.7 years, median 4 years. The total number offenestrations and branches in 87 patients was 266. Two hundred and ninefenestrations were followed for longer than a year.

Results: A total of 11 fenestrations and branches were occluded, 2 within thefirst year, 6 one year postoperatively, two fenestrations 2 yearspostoperatively, and one fenestration was occluded 6 years after procedure.One-year primary patency of fenestrations was 96.2%, three-year patency was95.1%, and five-year patency was 95.1%. During follow-up, we did not observe atype Ia endoleak in any patient.

Conclusion: Patency of fenestrations and branches in patients afterimplantation of fenestrated and branched stent-grafts for pararenal abdominalaortic aneurysm is good. The improvement of proximal fixation then leads to areduction in the risk of migration and the occurrence of a type Ia endoleak.

Keywords: pararenal abdominal aortic aneurysm, fenestrated stent-graft,bifurcated stent-graft, fenestration patency

Published: March 1, 2024  Show citation