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THE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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The Journal of Cardiovascular Surgery 2017 Jul 07

DOI: 10.23736/S0021-9509.17.10103-5

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

The role of surgeon modified fenestrated stent grafts in the treatment of aneurysms involving the branched visceral aorta

Benjamin J. PEARCE 1, Salvatore T. SCALI 2, Adam W. BECK 1

1 University of Alabama at Birmingham Division of Vascular Surgery and Endovascular Therapy, Birmingham, AL, USA; 2 University of Florida Division of Vascular Surgery and Endovascular Therapy, Gainesville, FL, USA


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Acceptance of endovascular technology has followed a predictable pattern in the treatment of aortic aneurysm disease. Initially, endovascular aneurysm repair (EVAR) was used to treat infrarenal abdominal aortic aneurysms (AAA) only in patients deemed medically unsuitable for open surgical repair (OSR). With improvement in device design, increased operative experience and favorable mortality benefits in randomized control trials, EVAR is now the preferred method for treatment of AAA worldwide. As the results with OSR are even worse as one ascends the aorta into the visceral segment and above, it stands to reason that EVAR technology to accommodate the aortic branches should have a similar adoption in treatment of proximal AAA and thoraco-abdominal aortic aneurysm (TAAA) disease. The first devices trialed and approved for treatment of the visceral aorta are custom manufactured and have had excellent results in complex pathology. However, there are several temporal, engineering and anatomic limitations to custom, manufactured branched and fenestrated endografts. Surgeon modified endovascular aneurysm repair (SM-EVAR) is able to overcome many of these constraints and expands this technology to more patients with excellent short term results in select centers.

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Publication History

Article first published online: July 7, 2017
Manuscript accepted: July 6, 2017
Manuscript received: July 6, 2017

Cite this article as

Pearce BJ, Scali ST, Beck AW. The role of surgeon modified fenestrated stent grafts in the treatment of aneurysms involving the branched visceral aorta. J Cardiovasc Surg 2017 Jul 07. DOI: 10.23736/S0021-9509.17.10103-5

Corresponding author e-mail

awbeck@uabmc.edu