Fenestrated Endovascular Aneurysm Repair versus Snorkel Endovascular Aneurysm Repair: Competing yet Complementary Strategies
10.5758/vsi.2019.35.3.121
- Author:
William J YOON
1
Author Information
1. Division of Vascular Surgery, Department of Surgery, University of California-Davis Medical Center, Sacramento, CA, USA. wjyoon@ucdavis.edu
- Publication Type:Review
- Keywords:
Complex aortic aneurysms;
Fenestrated;
Endovascular repair;
Snorkel
- MeSH:
Aneurysm;
Aorta;
Aortic Aneurysm;
Humans;
Learning Curve;
Neck;
Perfusion;
Transplants
- From:Vascular Specialist International
2019;35(3):121-128
- CountryRepublic of Korea
- Language:English
-
Abstract:
Juxtarenal/pararenal aortic aneurysms and type IV thoracoabdominal aneurysms pose particular technical challenges for endovascular repair as they involve the visceral segment in addition to insufficient infrarenal neck for the use of standard endovascular aneurysm repair (EVAR) devices. To overcome these challenges, complex EVAR techniques have been developed to extend the proximal landing zone cephalad with maintaining perfusion to vital aortic branches, thereby broadening the applicability of endografting from the infrarenal to the suprarenal aorta. Complex EVAR can be divided into two broad categories: fenestrated endovascular aneurysm repair (FEVAR) and snorkel EVAR. FEVAR is a valid procedure with the standardized procedure, although it remains as a relatively complex procedure with a learning curve. Given time constraints for the custom fenestrated graft, snorkel EVAR may be an alternative for complex repairs in symptomatic or ruptured patients for whom custom-made endografts may not be immediately available. This article discusses these two most commonly used complex EVAR strategies.
