Custom bifurcated stent-graft for abdominal aortic aneurysms: initial experience

Area of Science:

• Vascular Surgery
• Medical Device Technology
• Endovascular Interventions

Background:

• Abdominal aortic aneurysm (AAA) poses a significant risk, especially for patients unsuitable for conventional surgery.
• Endovascular aneurysm repair (EVAR) offers a less invasive alternative.
• Customized stent-graft designs may improve treatment outcomes for complex AAA cases.

Purpose of the Study:

• To describe the design and application of a custom bifurcated stent-graft.
• To evaluate the feasibility of this custom device for treating abdominal aortic aneurysms (AAA).

Main Methods:

• A custom modular bifurcated stent-graft was constructed using polyester grafts and Z stents.
• The device was implanted in five male patients (mean age 76 years) with AAA (mean diameter 4.7 cm) deemed high-risk for open surgery.
• Delivery involved large-bore sheaths (20-22F and 16F) via surgical exposure of the common femoral arteries.

Main Results:

• Successful stent-graft deployment without immediate complications in all five patients.
• No proximal or distal endoleaks were detected initially.
• At 6-month follow-up, four out of five aneurysms showed complete exclusion and shrinkage; one patient had a persistent leak but stable aneurysm size.

Conclusions:

• A custom bifurcated stent-graft can be effectively utilized for the endovascular treatment of abdominal aortic aneurysms.
• The initial results suggest promising outcomes for this custom device.
• Long-term follow-up is essential to fully assess the durability and efficacy of the custom stent-graft.