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.