Thirty-day outcomes after fenestrated endovascular repair are superior to open repair of abdominal aortic aneurysms involving visceral vessels

摘要

Abstract Objective Although few studies have reported outcomes after branched or fenestrated endovascular aortic aneurysm repair (FEVAR) of abdominal aortic aneurysms involving visceral vessels (AAA-Vs), no multi-institutional study has compared FEVAR with open surgery (OS) for AAA-Vs. Our objective was to compare 30-day outcomes after FEVAR vs OS for AAA-Vs. Methods Patients who underwent FEVAR (n? 535) and OS (n? 1207) for elective AAA-Vs were identified from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) 2008 to 2013 database. Thoracoabdominal aneurysms were excluded. Univariable and multivariable logistic regression analyses were performed. Results There were more men (82% vs 72%; P ?P ? .005), patients with dependent functional status (4% vs 2%; P ? .002), and nonsmokers (70% vs 56%; P ?P > .05). FEVAR had fewer major postoperative pulmonary complications (3.0% vs 19.0%; P ?P ?P ??001), less bleeding with major transfusion (17.4% vs 50.2%; P ?P ?P ? .02). The median length of stay was also significantly shorter for FEVAR (2燿ays vs 7燿ays; P ?Conclusions FEVAR is associated with a lower risk for 30-day mortality and adverse events compared with OS for AAA-Vs.