Fenestrated Physician-Modified Endografts for Preservation of Main and Accessory Renal Arteries in Juxtarenal Aortic Aneurysms
There is a paucity of reporting outcomes of complex aortic aneurysm treatment such as juxtarenal abdominal aortic aneurysms, where additional techniques to preserve renal artery perfusion are required. Retrospective analysis of consecutive patients who underwent emergent and elective aortic repair w...
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| Veröffentlicht in: | Journal of clinical medicine 2023-07, Vol.12 (14), p.4708 |
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| creator | Chan, Hon-Lai Papazoglou, Dimitrios D Jungi, Silvan Weiss, Salome Becker, Daniel Kotelis, Drosos Makaloski, Vladimir |
| description | There is a paucity of reporting outcomes of complex aortic aneurysm treatment such as juxtarenal abdominal aortic aneurysms, where additional techniques to preserve renal artery perfusion are required.
Retrospective analysis of consecutive patients who underwent emergent and elective aortic repair with fenestrated PMEGs between March 2019 and January 2023. Endpoints were technical success, reinterventions, secondary reinterventions and target vessel patency.
Forty-seven target vessels in 37 patients (23 male, median age 75 years) were targeted, of which 44 were renal arteries (RAs) with a mean diameter of 5.4 ± 1.0 mm. Thirteen were accessory RAs and six had a diameter ≤ 4 mm. Technical success rate was 87% overall; 97% for main and 62% for accessory RAs respectively. Target vessel patency and freedom from secondary reintervention was 100% and 97% at 30 days and 96% and 91% at one year, respectively. There was no 30-day mortality.
Fenestrated physician-modified endografts are safe and effective for the treatment of patients with juxtarenal abdominal aortic aneurysms when incorporating main renal arteries. Limited technical success may be expected when targeting accessory renal arteries, especially when small in diameter. Long-term follow-up is needed to confirm durability of PMEGs for renal artery preservation. |
| doi_str_mv | 10.3390/jcm12144708 |
| format | Article |
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Retrospective analysis of consecutive patients who underwent emergent and elective aortic repair with fenestrated PMEGs between March 2019 and January 2023. Endpoints were technical success, reinterventions, secondary reinterventions and target vessel patency.
Forty-seven target vessels in 37 patients (23 male, median age 75 years) were targeted, of which 44 were renal arteries (RAs) with a mean diameter of 5.4 ± 1.0 mm. Thirteen were accessory RAs and six had a diameter ≤ 4 mm. Technical success rate was 87% overall; 97% for main and 62% for accessory RAs respectively. Target vessel patency and freedom from secondary reintervention was 100% and 97% at 30 days and 96% and 91% at one year, respectively. There was no 30-day mortality.
Fenestrated physician-modified endografts are safe and effective for the treatment of patients with juxtarenal abdominal aortic aneurysms when incorporating main renal arteries. Limited technical success may be expected when targeting accessory renal arteries, especially when small in diameter. Long-term follow-up is needed to confirm durability of PMEGs for renal artery preservation.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm12144708</identifier><identifier>PMID: 37510822</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Aortic aneurysms ; Care and treatment ; Clinical medicine ; Health aspects ; Intervention ; Intubation ; Medical imaging ; Methods ; Mortality ; Patient outcomes ; Patients ; Renal artery ; Stents ; Vascular grafts ; Vascular surgery ; Veins & arteries</subject><ispartof>Journal of clinical medicine, 2023-07, Vol.12 (14), p.4708</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 by the authors. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-9a3b2d6aa17eaf9a945ada25845ee2a00ad78d26349e8b0f89550241244d336c3</citedby><cites>FETCH-LOGICAL-c477t-9a3b2d6aa17eaf9a945ada25845ee2a00ad78d26349e8b0f89550241244d336c3</cites><orcidid>0000-0001-9544-105X ; 0000-0001-8826-3232 ; 0000-0002-7743-5913</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416159/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416159/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37510822$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chan, Hon-Lai</creatorcontrib><creatorcontrib>Papazoglou, Dimitrios D</creatorcontrib><creatorcontrib>Jungi, Silvan</creatorcontrib><creatorcontrib>Weiss, Salome</creatorcontrib><creatorcontrib>Becker, Daniel</creatorcontrib><creatorcontrib>Kotelis, Drosos</creatorcontrib><creatorcontrib>Makaloski, Vladimir</creatorcontrib><title>Fenestrated Physician-Modified Endografts for Preservation of Main and Accessory Renal Arteries in Juxtarenal Aortic Aneurysms</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>There is a paucity of reporting outcomes of complex aortic aneurysm treatment such as juxtarenal abdominal aortic aneurysms, where additional techniques to preserve renal artery perfusion are required.
Retrospective analysis of consecutive patients who underwent emergent and elective aortic repair with fenestrated PMEGs between March 2019 and January 2023. Endpoints were technical success, reinterventions, secondary reinterventions and target vessel patency.
Forty-seven target vessels in 37 patients (23 male, median age 75 years) were targeted, of which 44 were renal arteries (RAs) with a mean diameter of 5.4 ± 1.0 mm. Thirteen were accessory RAs and six had a diameter ≤ 4 mm. Technical success rate was 87% overall; 97% for main and 62% for accessory RAs respectively. Target vessel patency and freedom from secondary reintervention was 100% and 97% at 30 days and 96% and 91% at one year, respectively. There was no 30-day mortality.
Fenestrated physician-modified endografts are safe and effective for the treatment of patients with juxtarenal abdominal aortic aneurysms when incorporating main renal arteries. Limited technical success may be expected when targeting accessory renal arteries, especially when small in diameter. Long-term follow-up is needed to confirm durability of PMEGs for renal artery preservation.</description><subject>Aortic aneurysms</subject><subject>Care and treatment</subject><subject>Clinical medicine</subject><subject>Health aspects</subject><subject>Intervention</subject><subject>Intubation</subject><subject>Medical imaging</subject><subject>Methods</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Renal artery</subject><subject>Stents</subject><subject>Vascular grafts</subject><subject>Vascular surgery</subject><subject>Veins & arteries</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptkt9rFDEQxxdRbKl98l0CvgiyNT83u09ylNYftFhEn8NcMnvNsZvUZLd4L_7t5ryzXMXkIcPMZ75hhm9VvWT0TIiOvlvbkXEmpabtk-qYU61rKlrx9CA-qk5zXtNy2lZypp9XR0IrRlvOj6tflxgwTwkmdOTmdpO99RDq6-h870vqIri4StBPmfQxkZuEGdM9TD4GEntyDT4QCI4srMWcY9qQrxhgIIs0YfKYSal_nn9OkHbpmCZvySLgnDZ5zC-qZz0MGU_370n1_fLi2_nH-urLh0_ni6vaSq2nugOx5K4BYBqh76CTChxw1UqFyIFScLp1vBGyw3ZJ-7ZTinLJuJROiMaKk-r9TvduXo7oLIYy8mDukh8hbUwEbx5Xgr81q3hvGJWsYaorCm_2Cin-mMvKzOizxWGAgHHOhreKCkaZbAr6-h90HedUxt9SUlDdqD-Ce2oFAxof-lg-tltRs9CqY0o0mhbq7D9UuQ5Hb2PA3pf8o4a3uwabYs4J-4chGTVby5gDyxT61eFeHti_BhG_AeMAvCA</recordid><startdate>20230715</startdate><enddate>20230715</enddate><creator>Chan, Hon-Lai</creator><creator>Papazoglou, Dimitrios D</creator><creator>Jungi, Silvan</creator><creator>Weiss, Salome</creator><creator>Becker, Daniel</creator><creator>Kotelis, Drosos</creator><creator>Makaloski, Vladimir</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9544-105X</orcidid><orcidid>https://orcid.org/0000-0001-8826-3232</orcidid><orcidid>https://orcid.org/0000-0002-7743-5913</orcidid></search><sort><creationdate>20230715</creationdate><title>Fenestrated Physician-Modified Endografts for Preservation of Main and Accessory Renal Arteries in Juxtarenal Aortic Aneurysms</title><author>Chan, Hon-Lai ; Papazoglou, Dimitrios D ; Jungi, Silvan ; Weiss, Salome ; Becker, Daniel ; Kotelis, Drosos ; Makaloski, Vladimir</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-9a3b2d6aa17eaf9a945ada25845ee2a00ad78d26349e8b0f89550241244d336c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aortic aneurysms</topic><topic>Care and treatment</topic><topic>Clinical medicine</topic><topic>Health aspects</topic><topic>Intervention</topic><topic>Intubation</topic><topic>Medical imaging</topic><topic>Methods</topic><topic>Mortality</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Renal artery</topic><topic>Stents</topic><topic>Vascular grafts</topic><topic>Vascular surgery</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chan, Hon-Lai</creatorcontrib><creatorcontrib>Papazoglou, Dimitrios D</creatorcontrib><creatorcontrib>Jungi, Silvan</creatorcontrib><creatorcontrib>Weiss, Salome</creatorcontrib><creatorcontrib>Becker, Daniel</creatorcontrib><creatorcontrib>Kotelis, Drosos</creatorcontrib><creatorcontrib>Makaloski, Vladimir</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chan, Hon-Lai</au><au>Papazoglou, Dimitrios D</au><au>Jungi, Silvan</au><au>Weiss, Salome</au><au>Becker, Daniel</au><au>Kotelis, Drosos</au><au>Makaloski, Vladimir</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fenestrated Physician-Modified Endografts for Preservation of Main and Accessory Renal Arteries in Juxtarenal Aortic Aneurysms</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2023-07-15</date><risdate>2023</risdate><volume>12</volume><issue>14</issue><spage>4708</spage><pages>4708-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>There is a paucity of reporting outcomes of complex aortic aneurysm treatment such as juxtarenal abdominal aortic aneurysms, where additional techniques to preserve renal artery perfusion are required.
Retrospective analysis of consecutive patients who underwent emergent and elective aortic repair with fenestrated PMEGs between March 2019 and January 2023. Endpoints were technical success, reinterventions, secondary reinterventions and target vessel patency.
Forty-seven target vessels in 37 patients (23 male, median age 75 years) were targeted, of which 44 were renal arteries (RAs) with a mean diameter of 5.4 ± 1.0 mm. Thirteen were accessory RAs and six had a diameter ≤ 4 mm. Technical success rate was 87% overall; 97% for main and 62% for accessory RAs respectively. Target vessel patency and freedom from secondary reintervention was 100% and 97% at 30 days and 96% and 91% at one year, respectively. There was no 30-day mortality.
Fenestrated physician-modified endografts are safe and effective for the treatment of patients with juxtarenal abdominal aortic aneurysms when incorporating main renal arteries. Limited technical success may be expected when targeting accessory renal arteries, especially when small in diameter. Long-term follow-up is needed to confirm durability of PMEGs for renal artery preservation.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>37510822</pmid><doi>10.3390/jcm12144708</doi><orcidid>https://orcid.org/0000-0001-9544-105X</orcidid><orcidid>https://orcid.org/0000-0001-8826-3232</orcidid><orcidid>https://orcid.org/0000-0002-7743-5913</orcidid><oa>free_for_read</oa></addata></record> |
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| source | PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Aortic aneurysms Care and treatment Clinical medicine Health aspects Intervention Intubation Medical imaging Methods Mortality Patient outcomes Patients Renal artery Stents Vascular grafts Vascular surgery Veins & arteries |
| title | Fenestrated Physician-Modified Endografts for Preservation of Main and Accessory Renal Arteries in Juxtarenal Aortic Aneurysms |
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