3D Models for Physician Modified Endografts
Marc Salhanick, Carlos Timaran
UTSW, Dallas, TX
Fenestrated endovascular aortic repair (FEVAR) requires intense planning with measurements from either centerline or multiplanar reconstruction (MPR). However subtle but important discrepancies can exist between these two measurement methods with increasing tortuosity. 3D printed models have been developed as an alternative means of measurement which could potentially bridge this gap. We report the case of a 72 year old man with expanding juxtarenal abdominal aortic aneurysm from Type 1a endoleak from previous repair. A thermoplastic polyurethane (TPU) 3D model was printed from a mask of the patient's arterial phase CTA. This was sterilized and utilized on the backtable to assist with planning four fenestrations to modify a Cook Alpha 30 x 109 mm. The device was reconstrained in 16F sheath and successfully implanted. His postoperative course was uneventful and he was discharged home on POD4. This case demonstrates the utility of 3D aortic modeling to arbitrate the disparity between centerline and MPR measurements with excellent technical result. 
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