{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T16:12:30Z","timestamp":1785514350713,"version":"3.56.0"},"reference-count":21,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Management of mycotic complex aortic aneurysms (MAAs) involving the supra-aortic or reno-visceral vessels is highly challenging. Radical open repair carries substantial mortality and morbidity and may not always be technically feasible. Fenestrated or branched endovascular aortic repair (F\/BEVAR) offers a less invasive alternative, although current experience remains limited. This study describes the outcomes of complex endovascular repair of MAAs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This single-center retrospective cohort study included all consecutive patients with MAA who underwent F\/BEVAR between November 2017 and August 2024. Mycotic aortic aneurysm diagnosis was established using a combination of clinical presentation, laboratory markers, and imaging findings according to current guidelines. All patients received broad-spectrum antibiotics at presentation before undergoing F\/BEVAR, followed by targeted antibiotics as appropriate. Collected data included patient demographics, operative details, early and long-term complications, infection-related complications (IRC), all-cause mortality, and infection-related mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 21 patients (81% male, mean age 73.3 \u00b1 5 years) were treated for MAAs affecting the aortic arch (n = 4), thoracoabdominal aorta (n = 9), or pararenal aorta (n = 8). Procedures involved in situ laser fenestration (n = 13), physician-modified endografts (n = 2), off-the-shelf branched devices (n = 2), and custom-made devices (n = 4). Technical success was 20\/21 (95.2%; 1 type IIIC endoleak), and no target vessel loss. No deaths occurred within 30 days postoperatively. Three early reinterventions (14.3%) were required. During a mean follow-up of 37.4 \u00b1 26.7 months, 2 asymptomatic renal branch occlusions were detected but did not require revascularization. Four patients (19%) developed IRCs at 1, 9, 9, and 13 months after the surgery, managed either conservatively with antibiotics alone (n = 2) or combined with computed tomography (CT)-guided drainage (n = 2), both of whom died 11 and 31 months after CT-guided drainage. The 3-year Kaplan-Meier estimated survival was 85% (95% CI = 58%-95%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Complex endovascular repair of MAAs is feasible, with high technical success and favorable short- to mid-term outcomes. Late IRCs do occur in some cases, but may be managed semi-conservatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>Patients with mycotic aneurysms involving aortic side branches are at increased risk when treated with open aortic repair. These results demonstrate that fenestrated and branched endovascular techniques represent a viable therapeutic option in this challenging patient population, yielding excellent short-term and acceptable mid-term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028261467582","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:48:23Z","timestamp":1785390503000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Fenestrated and Branched Endovascular Repair for Mycotic Aortic Aneurysms"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2962-5306","authenticated-orcid":false,"given":"Peter Tamas","family":"Legeza","sequence":"first","affiliation":[{"name":"Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Sweden"},{"name":"Department of Vascular and Endovascular Surgery, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Wanhainen","sequence":"additional","affiliation":[{"name":"Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Asciutto","sequence":"additional","affiliation":[{"name":"Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Saricilar","sequence":"additional","affiliation":[{"name":"Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Mani","sequence":"additional","affiliation":[{"name":"Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000457"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2019.05.004"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.009481"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.23736\/S0021-9509.17.10069-8"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2023.11.002"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.068587"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2023.01.005"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2024.12.041"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2020.06.011"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2022.11.024"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf449"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.09.060"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.024021"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2023.11.006"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.008104"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.08.004"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2023.08.039"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2025.12.157"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2021.07.025"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2021.06.039"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2025.07.003"}],"container-title":["Journal of Endovascular Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028261467582","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15266028261467582","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028261467582","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:47:33Z","timestamp":1785512853000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15266028261467582"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,29]]},"references-count":21,"alternative-id":["10.1177\/15266028261467582"],"URL":"https:\/\/doi.org\/10.1177\/15266028261467582","relation":{},"ISSN":["1526-6028","1545-1550"],"issn-type":[{"value":"1526-6028","type":"print"},{"value":"1545-1550","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,29]]},"article-number":"15266028261467582"}}