Outcomes and Imaging Surveillance Adherence in Juxta-Renal Aortic Aneurysms Repairs: A VASQIP Retrospective Study

Elective FEVAR is associated with lower perioperative mortality and morbidities compared to elective j-OSR for juxtarenal aortic aneurysms. However, the perioperative survival benefits of FEVAR diminish over time, with its mortality surpassing that of j-OSR at longer follow-up periods. The compliance with post-FEVAR imaging surveillance is also low. Further research is warranted to develop strategies to improve adherence to imaging surveillance protocols.Clinical ImpactThis study provides real-world evidence on the outcomes and follow-up adherence following fenestrated endovascular aortic repair (FEVAR) for juxtarenal abdominal aortic aneurysms (JAAA) in the Veterans Affairs health care system. With FEVAR's increasing use, the findings highlight the need for improved surveillance protocols, as adherence to postoperative imaging declines significantly after the first year. Clinicians should be aware of the risk of long-term mortality despite FEVAR's short-term benefits, urging better follow-up strategies that relay a survival benefit for patients.