Fenestrated and Branched Endovascular Aneurysm Repair: Global Trends, Complications, and Bibliometric Insights.

BACKGROUND

Fenestrated and branched endovascular aneurysm repair (F/BEVAR) has emerged as an advanced technique for the treatment of complex aortic aneurysms involving visceral and renal branches. Despite its increasing adoption, procedure-related complications remain a major concern, while the scientific landscape continues to evolve.

OBJECTIVE

To analyze the distribution of complications associated with F/BEVAR and evaluate global research trends through a combined clinical and bibliometric approaches.

METHODS

A retrospective clinical analysis of complications was performed using R (R Foundation for Statistical Computing, Vienna, Austria). A bibliometric analysis was conducted using VOSviewer to assess co-authorship, keyword co-occurrence, citation patterns, and journal distribution. Data were retrieved from the Scopus database using a predefined search strategy. A total of 646 records were identified, of which 529 publications were included after applying predefined selection criteria.

RESULTS

A total of 529 publications were analyzed. Scientific output demonstrated a sustained increase over time, with a marked acceleration after 2015 and a progressive rise in citation impact. Keyword co-occurrence analysis revealed a highly interconnected structure centered on procedural techniques, aneurysm characteristics, and clinical outcomes. Bibliographic coupling highlighted a partially fragmented citation network, particularly among recent publications, suggesting an evolving and rapidly expanding field. The United States was the leading contributor, followed by major European countries. From a reporting perspective, endoleak (36.3%) and occlusion (34.0%) were the most frequent complications, predominantly affecting renal branches (72.0%).

CONCLUSION

F/BEVAR research has experienced substantial growth over the past two decades, accompanied by a transition in research emphasis from technical feasibility toward outcome-driven and data-oriented investigation. This evolution reflects the maturation of the field but does not, in itself, imply improvement in clinical outcomes, which cannot be inferred from the bibliometric or text-mining data presented here. Endoleak and branch occlusion remain the most persistently and frequently reported complications, with a predominant involvement of renal branches, underscoring persistent technical challenges in target vessel preservation.