FENESTRATED ENDOVASCULAR AORTIC ANEURYSM REPAIR – PHYSICIANMODIFIED FENESTRATED ENDOGRAFTS IN TREATMENT OF COMPLEXABDOMINAL AND RUPTURED ANEURYSMS – CLINICAL EXPERIENCEFROM MHAT „HEART AND BRAIN“ – PLEVEN

Abstract

FEVAR–PMSGs (Fenestrated endovascular aortic aneurysm repair – physician modified endografts) – is an innovative minimally invasive technique that allows treatment and restoration of normal blood flow in thoraco-abdominal and/or complex abdominal aneurysms involving visceral arteries (arteries supplying the abdominal organs). Such type of interventions is performed in 3 hospital centers in Bulgaria. Clinic of Vascular Surgery „Heart and Brain“ – Pleven, is among the leaders in the country in the field of endovascular treatment of ruptured and symptomatic complex aortic aneurysms. Such type of aneurysms is one of the most challenging cases in the field of vascular surgery worldwide. The procedure uses stent-graft systems with fenestrae (openings) specially designed by the vascular surgeon, which allow blood flow to pass to the abdominal organs while isolating the aneurysm. In such diseases of the aorta, atherosclerotic changes and, accordingly, its expansion also involve the visceral arteries supplying vital abdominal organs with blood. Such conditions are extremely dynamically developing in which traditional open surgery as well as classical interventional techniques are ineffective. Very often patients are not familiar with the disease and seek medical help after complaints of rupture (bursting) of the aneurysmal sac. FEVAR–PMEGs is proven to be the technique of choice in about 30-40% of patients with abdominal aortic aneurysm and 100% choice in patients with complex abdominal aortic aneurysm. The method is characterized by a high success rate in planned and emergency clinical cases. The rapid recovery and reduced risk of short-term and long-term complications make it a viable choice for a large contingent of patients. With the following article, we present the technique, advantages and disadvantages of the method, clinical results in a group of patients in the clinic. For 2024, 12 such procedures were performed in Vascular Surgery „Heart and Brain“ – Pleven. This article will examine a sample of patients operated on during the first half of 2024.