Early Results of Fenestrated and Branched Endovascular Repair of Complex Aortic Aneurysms with a Custom-made National Device Available in the Brazilian Public Health System.

Autor:	Domingues BS; Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, University of São Paulo, Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil., Dalio MB; Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, University of São Paulo, Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil. Electronic address: mbdalio@usp.br., Miquelin DG; Division of Vascular and Endovascular Surgery, Department of Surgery, São Jose do Rio Preto Medical School, São José do Rio Preto, São Paulo, Brazil., Neto FR; Division of Vascular and Endovascular Surgery, Department of Surgery, São Jose do Rio Preto Medical School, São José do Rio Preto, São Paulo, Brazil., Reis LF; Division of Vascular and Endovascular Surgery, Department of Surgery, São Jose do Rio Preto Medical School, São José do Rio Preto, São Paulo, Brazil., Miquelin AR; Division of Vascular and Endovascular Surgery, Department of Surgery, São Jose do Rio Preto Medical School, São José do Rio Preto, São Paulo, Brazil., Godoy JMP; Division of Vascular and Endovascular Surgery, Department of Surgery, São Jose do Rio Preto Medical School, São José do Rio Preto, São Paulo, Brazil., Joviliano EE; Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, University of São Paulo, Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Annals of vascular surgery [Ann Vasc Surg] 2025 Jan; Vol. 110 (Pt A), pp. 91-98. Date of Electronic Publication: 2024 Sep 26.
DOI:	10.1016/j.avsg.2024.07.125
Abstrakt:	Background: Multicenter studies conducted in developed countries demonstrated that custom-made devices are safe, effective, and durable for treating complex abdominal aneurysms. However, the situation in developing countries, such as Brazil, is different. Funding and time to have the endoprosthesis delivered are the major concerns. In order to overcome these conditions, high-volume Brazilian university hospitals started gaining experience with a custom-made device produced in the country. Objective: The present study aimed to describe the practice of 2 tertiary centers and report the early results of fenestrated and branched endovascular repair of complex aortic aneurysms with a custom-made national device available in the Brazilian public health system. Methods: Retrospective analysis of all consecutive patients that underwent fenestrated and branched endovascular aneurysm repair (F/BEVAR) of complex aortic aneurysms using custom-made manufactured endoprosthesis in 2 tertiary centers from January 2020 to July 2022. Results: Thirteen cases were included (10 male, mean age 69 ± 9 years). 70% were complex abdominal aneurysms, and 30% were type II, III, and IV thoracoabdominal aneurysms (mean aneurysm diameter 69.2 ± 8.12 mm). F/BEVAR included 33 visceral arteries. The Apolo® device was used in all cases. Technical success was achieved in 12 out of 13 patients (92.3%). Thirty-day major adverse events included one death (7.7%), 5 acute renal failure (38.4%), 2 spinal cord ischemia (15.4%). The 1-year survival rate was 92.3%. Conclusions: Fenestrated and branched endovascular repair of complex aortic aneurysms with the custom-made Apolo® device has proven safe and effective in high-volume tertiary centers in the Brazilian public health system. Considering the complexity of the cases, the early patency of vessels and low initial mortality support this device continuation and expansion to treat complex aortic aneurysms in a developing country. (Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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