Risk factors of postoperative complications after F/B-TEVAR for aortic arch lesions: a multicenter retrospective analysis

Background Fenestrated/Branched Thoracic Endovascular Aortic Repair (F/B-TEVAR) has emerged as a cornerstone treatment for various acute and subacute complex aortic arch diseases, but the high complication rate of F/B-TEVAR surgery continues to plague many patients. Methods A retrospective analysis was conducted on 246 patients with aortic arch lesions who underwent F/B-TEVAR across 4 hospitals from February 2018 to December 2024. Case information and follow-up outcomes were analyzed using multivariate correlation calculation and multivariate logistic regression to summarize the risk factors associated with postoperative complications. Results Postoperative complications were observed in 53 cases (21.5%). Statistically significant risk factors (all P < 0.05) included history of previous cerebral infarction, history of smoking, lesions involving branch arteries, and the aortic wall pathology (aortic atherosclerotic plaque, minute intermural hematomas, mural thrombus). Conclusions This study identifies key independent risk factors for complications post F/B-TEVAR, emphasizing the potential benefit of 3D printing-assisted technology in reducing these risks. Further research is needed to validate these findings, which can help clinicians identify high-risk patients and implement appropriate interventions.