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The following is a summary of “Target Artery Outcomes Following Endovascular versus Open Surgical Repair of Thoracoabdominal Aortic Aneurysms – A Single Center Comparative Study,” published in the November 2024 issue of Surgery by Huang et al.
Few studies have compared target artery outcomes after endovascular incorporation and open reconstruction of thoracoabdominal aortic aneurysms (TAAAs).
Researchers conducted a retrospective study to compare target artery outcomes after fenestrated or branched endovascular aortic repair (FB-EVAR) vs. open surgical repair (OSR) of TAAAs.
They reviewed consecutive patients who had elective OSR or FB-EVAR for TAAAs (2008 and 2020). Target artery patency was evaluated using postoperative imaging. Data from patients who received FB-EVAR were obtained from a prospectively maintained institutional database.
The results showed 131 patients (487 target arteries) were treated with OSR, and 350 patients (1,300 target arteries) underwent FB-EVAR. In the OSR group, 440 target arteries (90.3%) were reconstructed by bypass, and 47 (9.7%) were reconstructed by reimplantation. In the FB-EVAR group, 841 target arteries (64.7%) were incorporated using fenestrations, and 459 (35.3%) were incorporated using double-barrel stents, 30-day primary patency rates were similar between FB-EVAR and OSR (99.4% vs. 99.0%, P=0.36). Still, secondary patency rates were higher after FB-EVAR (99.8% vs. 99.0%, P=0.02). Additionally, 3-year primary patency rates were 95.9% (95% CI, 94.7-97.2%) for FB-EVAR and 94.7% (95% CI, 92.2-97.2%) for OSR, with secondary patency rates of 98.5% (95% CI, 97.7-99.2%) and 94.7% (95% CI, 95.7-99.2%), respectively. No significant differences in late primary and secondary patency were found between the groups (P<0.05).
They concluded that both OSR and FB-EVAR resulted in high target artery patency rates, with no significant difference in late secondary patency between the 2 methods.
