Endovascular Aortic Arch repair with physician modified endograft (PMEG) device
Carla K Scott, Anna L Driessen, Jesus Porras Colon, Khalil H Chamseddin, Marilisa Soto Gonzalez, Felipe L Pavarino, Mirza S Baig, Carlos H Timaran
UT Southwestern Medical Center, Dallas, TX
Objective: In recent years, a clear shift has been observed towards thoracic endovascular aortic repair for different aortic pathologies. However, total endovascular repair of the aortic arch remains technically demanding. The aim of this video is to present an alternative to the current technical options for endovascular aortic arch repair using physician modified endografts (PMEG) with the assistance of 3D printing models.Methods: This video describes a PMEG approach for a total endovascular repair of a dissecting aortic arch aneurysm for which was ineligible for a company-manufactured endograft. A stepwise approach including details of the technique, clear intraoperative imaging and key take home points were included.Results: Completion angiography revealed patent branches and no endoleak. The patient ad an unremarkable recovery. A 30-day follow-up CT angiography demonstrated complete sac exclusion, patent branches and a type 2 endoleak from intercostal arteries. Conclusion: Endovascular repair of a dissecting aortic arch aneurysm using a physician modified endograft (PMEG) was feasible for a patient ineligible for a company-manufactured device. Durability and applicability of this technique remains to be elucidated.
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