Fenestrated and branched endovascular repair for post-dissection thoracoabdominal aortic aneurysms achieved a 96.0% technical success rate and a pooled MAE and early mortality rate of 4.6%.
Meta-Analysis (n=912)
Does fenestrated and branched endovascular repair (FEVAR and BEVAR) provide safe and effective outcomes in patients with post-dissection thoracoabdominal aortic aneurysms?
Complex endovascular repair (FEVAR and BEVAR) is a viable strategy for post-dissection thoracoabdominal aortic aneurysms with high technical success, though target vessel durability remains a limitation.
BACKGROUND: Endovascular repair using fenestrated and branched endografts (FEVAR and BEVAR) has emerged as an alternative to open surgery for post-dissection thoracoabdominal aortic aneurysms (PD-TAAA). However, outcomes remain heterogeneous and target vessel (TV) durability represents a major concern. This systematic review and meta-analysis aimed to evaluate clinical outcomes and TV-related events following FEVAR and BEVAR in PD-TAAA. METHODS: A systematic search of MEDLINE, Embase, and the Cochrane Library was conducted according to PRISMA guidelines. Studies reporting outcomes of fenestrated and/or branched endovascular repair for PD-TAAA were included. Outcomes were defined and scored according to the Society for Vascular Surgery reporting standards. The primary outcome was TV instability. Secondary outcomes included TV-related reintervention, major adverse events (MAE), and early and late mortality. Pooled event rates were calculated using random-effects meta-analysis. RESULTS: Seventeen retrospective studies including 912 patients and 3,229 TV were analyzed. Technical success was achieved in 96.0% of cases. In the overall analysis, pooled MAE and early mortality rate were 4.6% (I CONCLUSIONS: Complex endovascular repair represents a viable strategy for PD-TAAA, with high technical success and satisfactory mid-term outcomes. TV durability, particularly at the renal level, remains the main limitation, highlighting the need for standardized reporting and prospective studies with longer follow-up.
Luca et al. (2026) conducted a meta-analysis in post-dissection thoraco-abdominal aortic aneurysms (PD-TAAA) (n=912). Fenestrated and branched endovascular repair (FEVAR and BEVAR) was evaluated on Target vessel (TV) instability. Fenestrated and branched endovascular repair for post-dissection thoracoabdominal aortic aneurysms achieved a 96.0% technical success rate and a pooled MAE and early mortality rate of 4.6%.