Long-term Outcomes of Fenestrated and Branched Endovascular Aortic Repair for Complex Aortic Aneurysms in a High-volume Aortic Center

OBJECTIVE: This study presents the experience of a high-volume aortic center on fenestrated/branched endovascular aortic repair (f/bEVAR). BACKGROUND: Material and technique evolutions in f/bEVAR improved its outcomes but long-term data is limited. METHODS: Following STROBE, a retrospective single-center study of consecutive (elective/urgent) patients managed with f/bEVAR [custom-made (CMD) and off-the-shelf devices] between 2010 and 2024 was conducted. Technical success, 30-day mortality and spinal cord ischemia (SCI), and follow-up outcomes were analyzed. Multivariate logistic regression analyses were performed. RESULTS: A total of 916 patients were included (73.6% males, 71.7±0.6 y, 81.7% degenerative; 20.8% urgent). Juxtarenal aneurysms were managed in 33.5% and thoracoabdominal (TAAA) in 54.1%. Staging was performed in 26.0%. CMD were used in 74.4% (fenestrated: 37.1%; branched: 28.9%). Technical success was 93.6%, with urgent setting ( P