Dias-Neto, MarinaVacirca, AndreaHuang, YingBaghbani-Oskouei, AidinJakimowicz, TomaszMendes, Bernardo C.Kolbel, TiloSobocinski, JonathanBertoglio, LucaMees, BarendGargiulo, MauroDias, NunoSchanzer, AndresGasper, WarrenBeck, Adam W.Farber, Mark A.Mani, KevinTimaran, CarlosSchneider, Darren B.Pedro, Luís MTsilimparis, NikolaosHaulon, StéphanSweet, Matthew P.Ferreira, EmíliaEagleton, MatthewYeung, Kak KheeKhashram, ManarJama, KatarzynaPanuccio, GiuseppeRohlffs, FionaMesnard, ThomasChiesa, RobertoKahlberg, AndreaSchurink, Geert WillemLemmens, CharlotteGallitto, EnricoFaggioli, GianlucaKarelis, AngelosParodi, EzequielGomes, VivianWanhainen, AndersHabib, MohammedColon, Jesus PorrasPavarino, FelipeBaig, Mirza S.Gouveia e Melo, Ryan Eduardo Costeloe DeCrawford, SeanZettervall, Sara L.Garcia, RitaRibeiro, TiagoAlves, GonçaloGonçalves, Frederico BastosKappe, Kaj OlavMariko van Knippenberg, Samira ElizeTran, Bich LanGormley, SineadOderich, Gustavo S.2023-09-152023-09-152023Ann Surg. 2023 Oct 1;278(4):568-5770003-4932http://hdl.handle.net/10451/59326Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.This work was presented at the 143rd Annual Meeting of the American Surgical Association, Toronto, Ontario, Canada, April 20-22, 2023.Objective: To describe outcomes after elective and non-elective fenestrated-branched endovascular aortic repair (FB-EVAR) for thoracoabdominal aortic aneurysms (TAAAs). Background: FB-EVAR has been increasingly utilized to treat TAAAs; however, outcomes after non-elective versus elective repair are not well described. Methods: Clinical data of consecutive patients undergoing FB-EVAR for TAAAs at 24 centers (2006-2021) were reviewed. Endpoints including early mortality and major adverse events (MAEs), all-cause mortality, and aortic-related mortality (ARM), were analyzed and compared in patients who had non-elective versus elective repair. Results: A total of 2603 patients (69% males; mean age 72±10 year old) underwent FB-EVAR for TAAAs. Elective repair was performed in 2187 patients (84%) and non-elective repair in 416 patients [16%; 268 (64%) symptomatic, 148 (36%) ruptured]. Non-elective FB-EVAR was associated with higher early mortality (17% vs 5%, P <0.001) and rates of MAEs (34% vs 20%, P <0.001). Median follow-up was 15 months (interquartile range, 7-37 months). Survival and cumulative incidence of ARM at 3 years were both lower for non-elective versus elective patients (50±4% vs 70±1% and 21±3% vs 7±1%, P <0.001). On multivariable analysis, non-elective repair was associated with increased risk of all-cause mortality (hazard ratio, 1.92; 95% CI] 1.50-2.44; P <0.001) and ARM (hazard ratio, 2.43; 95% CI, 1.63-3.62; P <0.001). Conclusions: Non-elective FB-EVAR of symptomatic or ruptured TAAAs is feasible, but carries higher incidence of early MAEs and increased all-cause mortality and ARM than elective repair. Long-term follow-up is warranted to justify the treatment.engFenestrated-branched endovascular aortic repairThoracoabdominal aortic aneurysmNon-elective repairElective repairjournal article10.1097/SLA.00000000000059861528-1140