b'Scientific Session Abstracts SATURDAY APRIL 20, 2024 25: FENESTRATED/BRANCHED ENDOVASCULAR REPAIR OF THORACOABDOMINAL AORTIC ANEURYSMS: A CASE SERIESFROM A COMMUNITY HOSPITALAgustin Sibona, MD1, Pouria Parsa, MD 2 1 University of California San Diego,2Kaiser Permanent San DiegoIntroduction: Fenestrated/Branched Endovascular Aneurysm Repair (F/BEVAR) has established itself as a prominent therapy for managing complex thoracoabdominal aortic aneurysms (TAAA). However, the application of these techniques in a community hospital setting presents distinctive challenges. This study aims to articulate our experiences, shedding light on outcomes, technical nuances, and the routine incorporation of spinal drainage due to the unavailability of emergent rescue drainage.Cases Presentation: We present a case series featuring three patients with thoracoabdominal aortic aneurysms (TAAA). All patients underwent staged endovascular repair using Cook Endografts, with the routine placement of a spinal drain prior to the second stage, demonstrating no complications from the drains. The first stage involved repairing the thoracic portion of the aneurysm and coil embolization of visceral branches as needed, in preparation for the second stage F/BEVAR. Fenestrated/Branched devices were all physician-modified endografts (PMEGs) with Cook Endografts. The series encompasses detailed clinical profiles, procedural specifics, and postoperative outcomes.Discussion: Endovascular repair of TAAA in a community hospital setting is feasible with a well-established safety protocol addressing limitations. Our success in managing complex thoracoabdominal aortic aneurysms hinges on a safety protocol tailored to our resources. Despite the lack of evidence supporting the routine use of spinal drains, our decision to incorporate them stems from the unavailability of rescue drainage. This adaptive approach serves as a pragmatic solution in our setting, underscoring the importance of resource-conscious safety measures to optimize outcomes in these intricate interventions.Conclusion: Our study provides valuable insights into the management of TAAA in a community hospital. The shared outcomes and experiences contribute to the evolving knowledge base, guiding the optimization of procedural protocols and reaffirming the feasibility of these techniques in resource-constrained healthcare environments.42 NDANNUAL MEETING|APRIL 1921, 2024|OCEANSIDE, CA 73'