Physician-modified endovascular grafts for the treatment of elective, symptomatic, or ruptured juxtarenal aortic aneurysms

Journal of Vascular Surgery
Benjamin Ware Starnes

Abstract

To determine if a physician-modified endovascular graft (PMEG) is a safe and effective method of treating juxtarenal aortic aneurysms in patients considered to be unsuitable for open surgical repair. A retrospective, nonrandomized, single institution evaluation of the safety and efficacy of physician modification of a currently Food and Drug Administration-approved device (Zenith Flex; Cook Inc, Bloomington, Ind) to preserve branch vessels when used in the treatment of patients with elective, symptomatic, or ruptured juxtarenal aortic aneurysms. Forty-seven consecutive patients underwent fenestrated endovascular repair using PMEG over a 3-year period. Thirty-eight patients (80%) were symptomatic or had rapid aneurysm expansion. Eighty-five percent of patients were American Society of Anesthesiologist category III or IV. Eight-two fenestrations were created for 58 renal arteries, 16 superior mesenteric arteries, three celiac arteries, and the rest accessory vessels. Mean follow-up was 607 days, with a range of 425 to 1460 days. Mean contrast usage and fluoro time were 98 mL and 48 minutes. Technical success rate was 98%, and freedom from aneurysm-related death was 98%. There were six complications (13%). Three (6%) were access r...Continue Reading

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Citations

Apr 25, 2013·Journal of Vascular Surgery·Atsushi KitagawaTara M Mastracci
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Oct 12, 2018·Journal of Vascular Surgery·Seyed M QaderiBenjamin W Starnes

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