Pierie, Stijn (2025) Reinforcing the repair: Secondary branched or fenestrated endovascular aneurysm repair as a durable solution for type 1A endoleak. thesis, Medicine.
Full text available on request.Abstract
Background: The treatment of a failing endovascular aneurysm repair (EVAR) due to loss of proximal sealing is challenging. Branched or fenestrated endovascular aneurysm repair (B/FEVAR) offers a promising endovascular solution. This study evaluates B/FEVAR outcomes for managing type 1A endoleak after EVAR. Methods: All consecutive patients who underwent B/FEVAR surgery to treat a type 1A endoleak after EVAR at a large teaching hospital between 2019 and 2024 were included in this study. Outcomes analyzed included aneurysm-related mortality, overall survival, technical success, endoleaks, aneurysm sac dynamics, reinterventions, target vessel patency, target vessel instability, and other complications. Regular follow-up after B/FEVAR surgery included imaging at 1, 6, and 12 months, and annually thereafter. Results: Among 24 patients (96% male, median age 73 (range: 66-80), the median interval between EVAR and B/FEVAR was 6.6 years (range: 2-11). No aneurysm-related mortality was observed during follow-up. The median follow-up was 20 months (range: 3-67), and overall survival was 96%. The primary technical success rate was 88%, and the assisted primary technical success rate was 92%. Type 2 endoleaks were observed in 33% of patients, while type 3 endoleaks occurred in 13% of patients. Aneurysm sac regression during follow-up was reported in 17%, stabilization in 71%, and expansion in 13% of patients. Reinterventions were required in 25% of patients. Primary target vessel patency and assisted primary target vessel patency were 95% and 97%. Target vessel instability was 8%. Conclusion: B/FEVAR appears to be a safe, and effective option for managing type 1A endoleaks after prior EVAR based on midterm outcomes.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Schouten, Dr. Olaf |
| Faculty: | Medical Sciences |
| Date Deposited: | 22 Apr 2026 13:01 |
| Last Modified: | 22 Apr 2026 13:01 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3930 |
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