Endovascular repair of complex aortic aneurysms: comparison between surgeon-modified endografts and commercial branched devices in a high-complexity center

Conde Moncada R.; Ferreira L.M.; La Mura R.; Dávila O.; Cubas W.S. · Archivos Peruanos de Cardiologia y Cirugia Cardiovascular (2025) · DOI: 10.47487/apcyccv.v6i4.544

Resumen

Objective. Endovascular treatment of complex thoracoabdominal and paravisceral aortic aneurysms represents one of the most demanding challenges in endovascular surgery, driven by the development of new devices. This study aimed to describe the 30-day perioperative mortality, major postoperative complications, and reinterventions in patients treated for complex aortic aneurysms using off-the-shelf branched endografts (t-BRANCH) and Physician-Modified Endografts (PMEGs). Materials and Methods. This was a single-center, retrospective, observational study based on a prospectively collected database including all patients treated for complex aortic aneurysms and recorded in their medical records at our reference aortic center between January 2020 and December 2024. Results. A total of 51 patients were analyzed, with a mean age of 69.6 ± 10.3 years; 90.2% were male. The mean aneurysm diameter was 66.1 ± 15.2 mm. Overall mortality was 9.8%, with early in-hospital mortality of 23.1% in the T-Branch group compared to 5.3% in the PMEG group (p = 0.0977). Predictors of in-hospital mortality included an American Society of Anesthesiologists (ASA) physical status classification of IV (OR = 11.98; 95% CI: 1.46–98.7; p = 0.022) and a history of stroke (OR = 13.07; 95% CI: 1.06–161.5; p = 0.043). Conclusions. Endovascular repair of complex aortic aneurysms using PMEGs and t-BRANCH devices shows favorable results with respect to mortality and major postoperative complications associated with a low rate of reinterventions.