Physician-Modified Fenestrated Endovascular Aortic Aneurysm Repair After Failed EVAR with Type I Endoleak…

Cohort studyAnnals of vascular surgery· Aug 2026

Physician-Modified Fenestrated Endovascular Aortic Aneurysm Repair After Failed EVAR with Type I Endoleak Offers Favorable Results Compared to Open Conversion.

Jay P Natarajan, Trung Nguyen, Shivam Patel … Dean J Arnaoutakis

Vascular SurgeryCohort studyTreatment

Physician-modified fenestrated endovascular repair is associated with lower 30-day mortality.

Physician-Modified Fenestrated Endovascular Aortic Aneurysm Repair After Failed EVAR with Type I Endoleak Offers Favorable Results Compared to Open Conversion.

Jay P Natarajan … Dean J Arnaoutakis

Annals of vascular surgery · Aug 2026

Purpose

The purpose of this study was to compare outcomes of EVAR-c and PM-F/BEVAR in patients with prior EVAR with type Ia endoleak and to assess changes in our clinical management of these patients over time.

Methods

A prospective database of patients treated at a single-center with EVAR failure due to type Ia endoleak between January 2015 and November 2025 was retrospectively reviewed.

n = 101 patients

0%

Results

0%

30-day mortality was lower with physician-modified fenestrated endovascular repair

n = 101 patients

More results

Of the 101 patients treated for failed EVAR with type Ia endoleak, 41 underwent EVAR-c and 60 underwent PM-F/BEVAR.

There was no difference in 4-year overall survival (EVAR-c=64% vs PM-F/BEVAR=49%; p=0.71).

More results

The improved perioperative outcomes with PM-F/BEVAR was persistent when excluding urgent/emergent cases from analysis.

“

Conclusion

Endovascular salvage of failed prior EVAR due to type Ia endoleak with PM-F/BEVAR is safe and effective with significantly better 30-day outcomes compared to EVAR-c but this survival advantage is lost over time.

Physician-Modified Fenestrated Endovascular Aortic Aneurysm Repair After Failed EVAR with Type I Endoleak Offers Favorable Results Compared to Open Conversion.

Physician-Modified Fenestrated Endovascular Aortic Aneurysm Repair After Failed EVAR with Type I Endoleak Offers Favorable Results Compared to Open Conversion.

Related papers