Complex Endovascular Aortic Repair Shows 83 Percent Five Year Survival

Endovascular management of complex aortic aneurysms is increasingly utilized for patients at high surgical risk, with meta-analytical data demonstrating technical success rates of 98.5% for renal fenestrated repair and 97% for more complex configurations [1, 2]. While these endovascular techniques significantly reduce perioperative morbidity compared to open surgery, they carry a persistent risk of spinal cord ischemia (a condition where compromised blood supply to the spinal cord can lead to varying degrees of paralysis), with pooled rates reaching 12.3% in non-elective cases [2, 3, 4]. Long-term durability remains a critical consideration for the practicing clinician, as open surgery maintains a lower risk of reintervention at 24 months compared to fenestrated endovascular aortic repair (odds ratio 2.48; 95% confidence interval, 1.08 to 5.73) [4]. Furthermore, the risk of permanent renal failure requiring dialysis is 1.61% for complex endovascular repairs (95% confidence interval, 0.65% to 2.57%), particularly when suprarenal manipulation is required [5]. A new analysis from a high-volume center now provides essential longitudinal evidence to help clinicians weigh these procedural risks against long-term outcomes.