Juxtarenal (Short Neck) Aneurysms

Since the first endovascular aneurysm repair (EVAR) was performed in 1991 by Dr. Juan Parodi, EVAR has become the gold standard for treatment of AAA disease. EVAR offers lower mortality rates, shorter recovery times, and shorter hospital stays when compared to open surgery for AAA repair.

Unfortunately, over 40% of patients in need of repair have aortic anatomy that is not suitable for standard EVAR devices due to the presence of branch arteries or angulation of the aortic neck in the proximal graft anchor zone. These patients either go to open surgery, which is often associated with higher risks and longer recovery times, or undergo standard EVAR, which is frequently associated with suboptimal results.

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Fenestrated Endovascular Aneurysm Repair (FEVAR)

Fenestrated Endovascular Aneurysm Repair (FEVAR)
The presence of branch arteries near the aneurysm means that there is inadequate space to successfully and securely anchor a standard endograft without blocking blood flow to vital organs. By accurately creating fenestrations (or side holes) in the endograft that precisely correspond to the location of the patient’s branch arteries, the graft can be placed higher up in the aorta in healthy tissue against parallel arterial walls. This is designed to lead to three key benefits:

  1. Anchoring is secure, minimizing the likelihood of graft migration
  2. The graft is sealed tightly against the arterial walls, minimizing the likelihood of a type I endoleak
  3. Blood flow to vital organs is preserved
FEVAR offers compelling advantages. Physicians are able to treat patients with juxtarenal AAA using a less invasive, personalized solution specific to the patient’s unique anatomy. However, the challenge with providing FEVAR as a treatment option is that in its current form, FEVAR is highly complex, requires expensive equipment for proper measurements, and is time-consuming & costly. Consequently, very few physicians are able to, or choose to offer FEVAR to their patients.

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