Complex aneurysms involve the branches of the aorta above the kidney arteries, including the arteries to the bowel and liver. The application of endovascular aneurysm repair (EVAR) to treat aneurysms below the kidney arteries is now common place. However it is in the treatment of more complicated aortic aneurysms, where conventional treatment modalities carry a high mortality risk, that the benefit of EVAR can be even more appreciated. Such advances have changed the face of aortic surgery, offering less invasive treatments and also providing therapeutic options to patients previously deemed unfit for treatment. Read more about EVAR on our simple aneurysms page.
Complex aneurysms require the use of custom made stent grafts. This means that the stent graft is designed specifically according to the patient's own anatomy. These stent grafts require holes in them to incorporate the branches of the aorta.
Fenestrated devices have holes in the graft synchronized to the branches of the aorta and can therefore treat aneurysms that occur above the kidney arteries.
Aneurysms can extend beyond this region to include the area just below the heart. Aneurysms that extend from the heart down to the leg arteries require a series of stent grafts to be inserted into various arteries in order to exclude the aneurysm. A branched stent graft is often used for these cases.
The Royal Free Hospital specialises in repairing complex aneurysms and a large number of cases have been successfully carried out.