Comparison of fenestrated stentgrafts and open repair for juxtarenal aortic aneurysms using a propensity score matching - Université Paris-Est-Créteil-Val-de-Marne Access content directly
Journal Articles Annals of Vascular Surgery Year : 2023

Comparison of fenestrated stentgrafts and open repair for juxtarenal aortic aneurysms using a propensity score matching

Abstract

Objectives: The purpose of this study was to compare post-operative morbi-mortality and medium-term follow-up of fenestrated stentgrafting (FEVAR) and open repair (OR) for patients with juxtarenal aortic aneurysms (JRAAs). Materials and Methods: All consecutive patients who underwent custom-made FEVAR or open repair for complex abdominal aortic aneurysm (AAA) between 2005 and 2017 in two tertiary centers were scrutinized. Patients with JRAA constituted the study group. Suprarenal and thoracoabdominal aortic aneurysms were excluded. The groups were made comparable through the use of a propensity score matching. Results: 277 patients with JRAAs were included, 102 (36.8%) in the FEVAR group and 175 (63.2%) in the OR group respectively. After propensity score matching, 54 FEVAR patients (52.9%) and 103 OR patients (58.9%) were included for analysis. In-hospital mortality rates were 1.9% (n=1) in the FEVAR group vs. 6.9% (n=7) in the OR group (p=.483). Postoperative complications were less common in the FEVAR group (14.8% vs. 30.7%; p=.033). Mean follow-up was 42.1 months in the FEVAR group and 40 months in the OR group. Overall mortality rates at 12 and 36 months were 11.5% and 24.5% in the FEVAR group vs. 9.1 % (p=.691) and 11.6% (p=.067) in the OR group. Late reinterventions were more frequent in the FEVAR group (11.3% vs. 2.9%; p=.047). However, freedom from reintervention rates were not significantly different at 12 months (FEVAR: 86% vs. OR: 90%; p=.560) and 36 months (FEVAR: 86% vs. OR: 88.4%, p=.690). In the FEVAR group, persistent endoleak during follow-up was identified in 11.3% of cases. Conclusion: In the present study, there was no statistical difference in terms of mortality, in-hospital, at 12 or 36 months, between FEVAR and OR groups for JRAA. FEVAR for JRAA was associated with a significant reduction of overall postoperative major complications compared with OR. There were significantly more late reinterventions in the FEVAR group.
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Monday, September 30, 2024
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Monday, September 30, 2024
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hal-04212539 , version 1 (20-09-2023)

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Alia Bizos, Aurélien Hostalrich, Xavier Chaufour, Pascal Desgranges, Richard Layese, et al.. Comparison of fenestrated stentgrafts and open repair for juxtarenal aortic aneurysms using a propensity score matching. Annals of Vascular Surgery, 2023, 95, pp.50-61. ⟨10.1016/j.avsg.2023.05.031⟩. ⟨hal-04212539⟩

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