Tabular review of fenestrated-branched endovascular aortic repair for complex abdominal aortic aneurysms.

INTRODUCTION Complex abdominal aortic aneurysms (CAAAs) present challenges for standard endovascular aneurysm repair (EVAR) due to their proximity to critical vessels. Advanced techniques like fenestrated and branched endovascular aortic repair (FB-EVAR) enable precise exclusion of the aneurysm while preserving organ perfusion. With continuous technological and procedural evolution, FB-EVAR has become a promising, minimally invasive alternative to open repair in appropriately selected patients.

EVIDENCE ACQUISITION The published literature for single-center and multicenter studies evaluating the outcomes of FB-EVAR for CAAAs was searched using MEDLINE and Embase databases. Studies published between January 1st 2010 and January 1st 2025, in the English language which provided data on FB-EVAR of CAAAs with more than fifty reported cases were included.

EVIDENCE SYNTHESIS The average age of patients at the time of repair was 73.7 years, with males comprising the majority (85.8%). The most common aneurysm presentation was juxtarenal (47.8%), followed by pararenal (10.5%). Early mortality for the entire cohort was 2% and the most common early adverse event was acute kidney injury (6.2%).

CONCLUSIONS FB-EVAR for the treatment of CAAA has undergone significant evolution over the past decades and continues to advance, representing a promising and increasingly viable approach to this disease.