Systematic review and meta-analysis on the outcomes after fenestrated-branched endovascular repair in post-dissection thoracoabdominal aortic aneurysms.

Luca M, Lorenzo G, Mario D, +5 more, Franco VG.

Systematic ReviewAbstract only — full text under license

AI summary — for doctors, generated from the abstract only

Fenestrated-branched repair of post-dissection thoracoabdominal aneurysms has high technical success, but target-vessel durability, especially renal, is the main weakness.

What was studied

Systematic review and random-effects meta-analysis of 17 retrospective studies (912 patients, 3,229 target vessels) of FEVAR/BEVAR for post-dissection TAAAs.

Key findings

Technical success was 96.0%, pooled major adverse events 4.6%, and early mortality 4.1%.
Mean follow-up was 23.5 months with pooled mortality 12.8%, target-vessel instability 7.6% and TV reintervention 6.9%.
Renal arteries had more instability (4.0%) and reintervention (4.1%) than visceral arteries (3.1%, 2.9%).

Clinical relevance

Complex endovascular repair is a viable option for post-dissection TAAAs, but target-vessel surveillance matters.

Who should care

Cardiothoracic & Vascular SurgeryGeneral SurgeryVascular Surgery

Limitations

All studies were retrospective with heterogeneous reporting, so FEVAR could not be compared with BEVAR.

Follow renal and visceral branches closely after repair and consider referral for this repair at experienced centers.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

Background

Endovascular aortic repair using fenestrated and branched endografts [fenestrated endovascular aortic repair (FEVAR) and branched endovascular aortic repair (BEVAR)] has emerged as an alternative to open surgery for post-dissection thoracoabdominal aortic aneurysms (PD-TAAAs). However, outcomes remain heterogeneous and target vessel (TV) durability represents a major concern. This systematic review and meta-analysis aimed to evaluate clinical outcomes and TV-related events following FEVAR and BEVAR for PD-TAAAs.

Methods

A systematic search of MEDLINE, Embase, and the Cochrane Library was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting outcomes of fenestrated and/or branched endovascular repair for PD-TAAAs were included. Outcomes were defined and scored according to the Society for Vascular Surgery reporting standards. The primary outcome was TV instability. Secondary outcomes included TV-related reintervention, major adverse events (MAE), and early and late mortality. Pooled event rates were calculated using random-effects meta-analysis.

Results

Seventeen retrospective studies including 912 patients and 3229 TV were analyzed. Technical success was achieved in 96.0% of cases. In the overall analysis, pooled major adverse events and early mortality rate were 4.6% (I2 = 80%) and 4.1% (I2 = 0%), respectively. After a mean follow-up of 23.5 months, pooled mortality was 12.8% (I2 = 43%); TV instability and TV reintervention were 7.6% (I2 = 58%) and 6.9% (I2 = 35%), respectively. When reported, renal arteries showed higher rates of TV instability (4.0%, I2 = 32%) and TV-related reintervention (4.1%, I2 = 48%) compared with visceral arteries (3.1%; I2 = 55% and 2.9%, I2 = 56%, respectively). Owing to the high degree of heterogeneity in outcome reporting, a direct comparison between FEVAR and BEVAR was not feasible.

Conclusions

Complex endovascular repair represents a viable strategy for PD-TAAAs, with high technical success and satisfactory midterm outcomes. TV durability, particularly at the renal level, remains the main limitation, highlighting the need for standardized reporting and prospective studies with longer follow-up.

DOI

10.1016/j.jvs.2026.05.053

PMID

42320804

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

Want more like this?

Browse more from the feed. A free account unlocks the full feed, saving and communities.

Back to the research feed

Create a free account · Sign in