Patel, SR; Roy, IN; McWilliams, RG; Brennan, JA; Vallabhaneni, SR; Neequaye, SK; Smout, JD; Fisher, RK
(2021)
Characterising the incidence and mode of visceral stent failure after fenestrated endovascular aneurysm repair (FEVAR).
JRSM Cardiovascular Disease, 10.
p. 204800402110125.
ISSN 2048-0040
https://doi.org/10.1177/20480040211012503
SGUL Authors: Roy, Iain Nicholas
Abstract
Background
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.
Methods
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.
Results
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.
Conclusion
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
|
Additional Information: |
© The Author(s) 2021
https://creativecommons.org/licenses/by-nc/4.0/Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
SGUL Research Institute / Research Centre: |
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) |
Journal or Publication Title: |
JRSM Cardiovascular Disease |
ISSN: |
2048-0040 |
Language: |
en |
Dates: |
Date | Event |
---|
28 April 2021 | Published Online | 1 April 2021 | Accepted |
|
Publisher License: |
Creative Commons: Attribution-Noncommercial 4.0 |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/113304 |
Publisher's version: |
https://doi.org/10.1177/20480040211012503 |
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