OBJECTIVE To compare target artery (TA) outcomes after fenestrated or branched endovascular aortic repair (FB-EVAR) versus open surgical repair (OSR) of thoracoabdominal aortic aneurysms (TAAAs). BACKGROUND Few studies have compared TA outcomes after endovascular incorporation and open reconstruction. METHODS Among consecutive patients who underwent elective OSR or FB-EVAR of TAAAs (2008-2020), we reviewed those who had postoperative imaging studies evaluating TA. Data of FB-EVAR patients were obtained from a prospectively maintained institutional database. TAs included celiac, superior mesenteric, right and left renal arteries treated during TAAA repairs. Primary endpoint was TA patency (primary and secondary). RESULTS There were 131 patients (487 TAs) treated by OSR and 350 (1,300 TAs) by FB-EVAR. In the OSR group, 440 TAs (90.3%) were reconstructed by bypasses, and 47 (9.7%) by reimplantation. In the FB-EVAR group, 841 TAs (64.7%) were incorporated by fenestrations, and 459 (35.3%) by DBs. Thirty-day TA primary patency rates were not significantly different between FB-EVAR and OSR (99.4%% vs. 99.0%, P=0.36), but secondary patency rate was higher after FB-EVAR (99.8% vs. 99.0%, P=0.02). Three-year primary patency rates were 95.9% (95% confidence interval [CI], 94.7-97.2%) and 94.7% (95% CI, 92.2-97.2%), respectively; secondary patency rates were 98.5% (95% CI, 97.7-99.2%) and 94.7% (95% CI, 95.7-99.2%), respectively. There were no significant differences in late primary patency and secondary patency between groups (each P<0.05). CONCLUSION Target artery primary and secondary patency rates following elective OSR or FB-EVAR were high. Endovascular repair was not associated with loss of primary patency and late secondary patency.

中文翻译：

---

胸腹主动脉瘤血管内修复与开放手术修复后的目标动脉结果 - 一项单中心比较研究。


目的 比较胸腹主动脉瘤 （TAAA） 开孔或分支血管内修复术 （FB-EVAR） 与开放手术修复 （OSR） 后的目标动脉 （TA） 结局。背景 很少有研究比较血管内掺入和开放重建后的 TA 结局。方法 在连续接受择期 OSR 或 TAAA FB-EVAR 的患者 （2008-2020） 中，我们回顾了那些进行术后影像学研究评估 TA 的患者。FB-EVAR 患者的数据来自前瞻性维护的机构数据库。TAs 包括在 TAAA 修复期间治疗的乳糜泻、肠系膜上动脉、右肾和左肾动脉。主要终点是 TA 通畅性 （主要和次要）。结果 有 131 例患者 （487 例 TAs） 接受 OSR 治疗，350 例 （1,300 例 TAs） 接受 FB-EVAR 治疗。在 OSR 组中，440 例 TA （90.3%） 通过旁路重建，47 例 （9.7%） 通过再植入重建。在 FB-EVAR 组中，841 例 TA （64.7%） 通过开窗结合，459 例 （35.3%） 通过 DB 结合。FB-EVAR 和 OSR 之间 30 天 TA 初次通畅率无显著差异 （99.4%% vs. 99.0%，P=0.36），但 FB-EVAR 后继发通畅率较高 （99.8% vs. 99.0%，P=0.02）。三年初次通畅率分别为 95.9% （95% 置信区间 [CI]，94.7-97.2%） 和 94.7% （95% CI，92.2-97.2%）;继发通畅率分别为 98.5% （95% CI， 97.7-99.2%） 和 94.7% （95% CI， 95.7-99.2%）。两组间晚期一期通畅率和二期通畅率差异无统计学意义 （各 P<0.05）。结论 择期 OSR 或 FB-EVAR 后目标动脉一期和二期通畅率高。血管内修复与一期通畅丧失和晚期继发通畅无关。