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Related Experiment Video

Updated: Sep 16, 2025

An “All-laser” Endothelial Transplant
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Automated Laser Modified EndoGraft (ALMEG).

Wajdi Alrawi1, Samuel Saers1, Robert C Lind1

  • 1Thoracic and Cardiovascular Centre, Linköping University Hospital, Linköping, Sweden.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|July 8, 2025
PubMed
Summary

Automated Laser Modified EndoGraft (ALMEG) offers a faster, more precise method for complex aortic aneurysm repair. This innovation streamlines endograft modification, reducing human error in critical situations.

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Preloaded Physician-Modified Thoracic Endovascular Aortic Repair to Achieve Left Subclavian Artery Fenestration Alignment in Zone 2.

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Technical Approach to Rescuing a Previous Physician-Modified Endovascular Graft with a New Physician-Modified Endovascular Graft.

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Area of Science:

  • Vascular Surgery
  • Medical Device Technology
  • Aortic Aneurysm Repair

Background:

  • Complex aortic aneurysms present significant challenges for endovascular repair.
  • Existing physician-modified endografts (PMEG) can be time-consuming and prone to human error.

Purpose of the Study:

  • To detail the technical aspects of the Automated Laser Modified EndoGraft (ALMEG) technique.
  • To present the first clinical case utilizing this novel endograft modification method.

Main Methods:

  • Development of a planning program using CT angiography data for patient-specific templates.
  • Automated laser fenestration of endografts based on identified optimal positions.
  • Reinforcement of fenestrations with nitinol wire and addition of diameter-reducing ties.
Keywords:
abdominal aortic aneurysmaortic ruptureendograftendovascular aneurysm repairfenestrationphysician modified endograftthoracic aortic aneurysmthoracoabdominal aortic aneurysm

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Main Results:

  • ALMEG provides a standardized and automated approach to endograft modification.
  • The laser system ensures high precision and speed in creating fenestrations.
  • The method is designed to minimize human error and expedite the procedure.

Conclusions:

  • ALMEG represents a significant advancement over traditional PMEG, enhancing speed and accuracy.
  • This technique offers a promising solution for complex aortic aneurysm repair, especially in emergency settings.
  • Potential for further optimization through artificial intelligence integration exists for broader clinical application.