Fenestrated Stent Grafting for Aortic Aneurysm in Europe

Abstract

In this issue of the journal, Amiot et al. and Verhoeven et al. presented their experience of fenestrated stent grafting for short-necked and juxta-renal abdominal aortic aneurysms. Amiot et al. report a series of 134 consecutive patients treated during a 4-year period in 16 French academic hospitals. In this series, 403 visceral vessels were perfused through a fabric fenestration. Only one acute surgical conversion was necessary and discharge computed tomography (CT) scan showed that 99% of target vessels were patent. The 30-day mortality rate was 2%. The median duration of follow-up was 15 months with no rupture or surgical conversion. During this period, four renal artery occlusions were detected. Twelve procedure-related reinterventions were done. In parallel, Verhoeven reports an 8-year experience of a single tertiary reference centre in Groningen with 100 consecutive patients managed with a fenestrated stent graft. In this series, 99% of the target vessels were patent. The 30-day mortality was 1% with one acute surgical conversion. Median follow-up was 24 months with three renal artery occlusions and 25 patients presenting with a significant increase in serum creatinine, two of them requiring dialysis. These two outstanding articles represent together the largest experience of fenestrated stent-graft repair ever published. They both support the concept described by Greenberg that placement of fenestrated endovascular