Characterising the incidence and mode of visceral stent failure after fenestrated endovascular aneurysm repair (FEVAR).



Patel, Shaneel R ORCID: 0000-0002-4388-2619, Roy, Iain N ORCID: 0000-0001-9701-8319, McWilliams, Richard G, Brennan, John A, Vallabhaneni, Srinivasa R, Neequaye, Simon K, Smout, Jonathan D and Fisher, Robert K
(2021) Characterising the incidence and mode of visceral stent failure after fenestrated endovascular aneurysm repair (FEVAR). JRSM cardiovascular disease, 10. 20480040211012503-.

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Abstract

<h4>Background</h4>In FEVAR, visceral stents provide continuity and maintain perfusion between the main body of the stent and the respective visceral artery. The aim of this study was to characterise the incidence and mode of visceral stent failure (type Ic endoleak, type IIIa endoleak, stenosis/kink, fracture, crush and occlusion) after FEVAR in a large cohort of patients at a high-volume centre.<h4>Methods</h4>A retrospective review of visceral stents placed during FEVAR over 15 years (February 2003-December 2018) was performed. Kaplan-Meier analyses of freedom from visceral stent-related complications were performed. The outcomes between graft configurations of varying complexity were compared, as were the outcomes of different stent types and different visceral vessels.<h4>Results</h4>Visceral stent complications occurred in 47/236 patients (19.9%) and 54/653 stents (8.3%). Median follow up was 3.7 years (IQR 1.7-5.3 years). There was no difference in visceral stent complication rate between renal, SMA and coeliac arteries. Visceral stent complications were more frequent in more complex grafts compared to less complex grafts. Visceral stent complications were more frequent in uncovered stents compared to covered stents. Visceral stent-related endoleaks (type Ic and type IIIa) occurred exclusively around renal artery stents. The most common modes of failure with SMA stents were kinking and fracture, whereas with coeliac artery stents it was external crush.<h4>Conclusion</h4>Visceral stent complications after FEVAR are common and merit continued and close long-term surveillance. The mode of visceral stent failure varies across the vessels in which the stents are located.

Item Type: Article
Uncontrolled Keywords: Vascular, aneurysm, complex, complications, endovascular, fenestrated, stent
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 25 Oct 2022 15:49
Last Modified: 18 Jan 2023 19:49
DOI: 10.1177/20480040211012503
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3165759