Fenestrated EVAR Promotes Positive Infrarenal Neck Remodeling Leading to Greater Sac Shrinkage Compared With EVAR

Abstract

The standard of care treatment for abdominal aortic aneurysms (AAAs) in the modern era is endovascular aneurysm repair (EVAR). Numerous devices exist for standard infrarenal AAA repair, but in patients with short infrarenal necks, fenestrated endovascular aneurysm repair (fEVAR) offers a minimally invasive alternative to traditional open repair. Over time, aortic neck dilation can occur in the segment used as a seal zone, leading to loss of seal, endoleaks, and AAA sac growth. This study compares aortic remodeling post EVAR vs fEVAR and evaluates if fEVAR confers a benefit in terms of sac shrinkage.