{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T05:01:44Z","timestamp":1789794104568,"version":"4.0.1"},"reference-count":29,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"IMSS-BIENESTAR","award":["PP Q008"],"award-info":[{"award-number":["PP Q008"]}],"id":[{"id":"https:\/\/ror.org\/02j4pwj98","id-type":"ROR","asserted-by":"crossref"}]},{"award":["PP Q008"],"award-info":[{"award-number":["PP Q008"]}],"id":[{"id":"https:\/\/ror.org\/02j4pwj98","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background: Explantation after chimney, fenestrated, or branched endovascular aortic repair is technically demanding because major arterial branches are incorporated into the device. Objective: To identify recurring principles of operative decision-making for partial or complete explantation, with an emphasis on infection extent, incorporated branch management, reconstruction, and staging. Methods: PubMed\/MEDLINE and Scopus were searched from inception through 21 August 2026 for patient-level reports of surgical explantation after complex endovascular aortic repair. Two reviewers independently selected studies, extracted data, and assessed methodological quality with the Joanna Briggs Institute checklist and reporting completeness with CARE. Findings were synthesized descriptively; the protocol was registered in PROSPERO (CRD420261412667). Results: Ten single-patient reports published from 2015 to 2025 were included. Patients were aged 51\u201378 years (median, 73), and nine were men. Infection prompted eight explantations; renal chimney-stent thrombosis with type Ia endoleak and persistent type II endoleak with sac enlargement accounted for two mechanical failures. Computed tomography or computed tomography angiography was reported in all cases and FDG-PET\/CT in five. Eight patients underwent complete and two partial explantations. Nine survived the index hospitalization. No recurrent infection was reported during the available, heterogeneous follow-up of 3\u201348 months. Conclusions: These selected reports identify anatomy- and source-control considerations that may guide operative planning, but they do not establish comparative effectiveness, procedural safety, or population-level outcomes.<\/jats:p>","DOI":"10.3390\/medsci14050574","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:50:27Z","timestamp":1789566627000},"page":"574","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anatomy of a Rescue: Explantation and Reconstruction After Complex Endovascular Aortic Repair\u2014A Systematic Review of Case Reports"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8419-6180","authenticated-orcid":false,"given":"Luis O.","family":"Bobadilla-Rosado","sequence":"first","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8876-5937","authenticated-orcid":false,"given":"Luis H.","family":"Arzola-Flores","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Arturo","family":"Hinojosa-Becerril","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0091-8131","authenticated-orcid":false,"given":"Maria Jos\u00e9","family":"Sanabrais-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Hospital Regional Elvia Carrillo Puerto, ISSSTE, M\u00e9rida 97001, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Azueta-Cervera","sequence":"additional","affiliation":[{"name":"Hospital Regional de Alta Especialidad de la Pen\u00ednsula de Yucat\u00e1n, IMSS-Bienestar, M\u00e9rida 97300, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiola","family":"Velazquez-Castro","sequence":"additional","affiliation":[{"name":"Hospital Regional de Alta Especialidad de la Pen\u00ednsula de Yucat\u00e1n, IMSS-Bienestar, M\u00e9rida 97300, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0499-165X","authenticated-orcid":false,"given":"Osvaldo","family":"Huchim-Mendez","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad An\u00e1huac Mayab, M\u00e9rida 97310, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0230-0731","authenticated-orcid":false,"given":"Nina","family":"Mendez-Dom\u00ednguez","sequence":"additional","affiliation":[{"name":"Hospital Regional de Alta Especialidad de la Pen\u00ednsula de Yucat\u00e1n, IMSS-Bienestar, M\u00e9rida 97300, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1161\/CIRCULATIONAHA.123.068234","article-title":"Early and late aortic-related mortality and rupture after fenestrated-branched endovascular aortic repair of thoracoabdominal aortic aneurysms: A prospective multicenter cohort study","volume":"150","author":"Oderich","year":"2024","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jvs.2013.07.009","article-title":"Outcomes of fenestrated endovascular repair of juxtarenal aortic aneurysm","volume":"59","author":"Kristmundsson","year":"2014","journal-title":"J. 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