{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T10:18:23Z","timestamp":1778062703578,"version":"3.51.4"},"reference-count":22,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Fenestrated and branched endovascular aortic repair (F\/BEVAR) is increasingly used for the treatment of complex aortic aneurysms, and is traditionally performed under general anesthesia (GA). Data on the use of local anesthesia (LA) for F\/BEVAR remain limited. This study aimed to report early outcomes of F\/BEVAR performed under LA versus GA, with a focus on feasibility and perioperative complications in a high-risk patient population. Methods: This single-center retrospective analysis included patients undergoing F\/BEVAR under LA or GA. Primary outcomes were in-hospital mortality and in-hospital complications. Secondary outcomes included early reintervention, intensive care unit and hospital length of stay, blood transfusion requirements, and technical success. Results: A total of 359 patients were included, of whom 25 (7.0%) were treated under LA and 334 (93.0%) under GA. Conversion from LA to GA occurred in 6 patients (24%). Patients in the LA group represented a higher-risk cohort, with advanced age, higher ASA class, larger aneurysm diameters, and a greater proportion of emergency and ruptured repairs. Technical success was high, and procedural metrics were within expected ranges. In-hospital mortality was numerically higher in the LA group (12.0% vs. 2.9%, p = 0.05). Overall, in-hospital complications were more frequent in the LA group (68.0% vs. 41.3%, p = 0.009), including a higher rate of spinal cord ischemia (24.0% vs. 8.5%, p = 0.02). Blood transfusion requirements were also greater in patients treated under LA (p = 0.004), while blood loss, ICU stay, and hospital length of stay were comparable. Early reintervention occurred more frequently in the LA group (31.8% vs. 10.4%, p = 0.009). Conclusions: LA appears feasible in selected high-risk patients undergoing complex F\/BEVAR. However, given substantial baseline differences between groups, no conclusions can be drawn regarding comparative safety or efficacy relative to GA. These findings should be considered preliminary.<\/jats:p>","DOI":"10.3390\/jcm15093257","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T14:28:23Z","timestamp":1777040903000},"page":"3257","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Local Anesthesia for Complex F\/BEVAR in a High-Risk Cohort: A Single-Center Feasibility Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Natasha","family":"Hasemaki","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, University Hospital LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5614-2388","authenticated-orcid":false,"given":"Ihza","family":"Fachriza","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"},{"name":"Division of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia"},{"name":"Division of Vascular and Endovascular Surgery, Clinical Department of Cardiovascular, Cipto Mangunkusumo National Hospital, Jakarta 10430, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Stana","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexia-Vasiliki","family":"Amvrazi","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Khangholi","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tugce","family":"\u00d6z","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Konstantinou","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6313-7595","authenticated-orcid":false,"given":"Nikolaos","family":"Tsilimparis","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.ejvs.2023.02.069","article-title":"Editor\u2019s Choice\u2014Single Centre Midterm Experience with Primary Fenestrated Endovascular Aortic Aneurysm Repair for Short Neck, Juxtarenal, and Suprarenal Aneurysms","volume":"66","author":"Katsargyris","year":"2023","journal-title":"Eur. 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