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Benchmark Results for Physician-Modified Endografts.

Carrie Tackett1, Tyler Liang1, Sukgu M Han1

  • 1Comprehensive Aortic Center, Keck Medical Center of University of Southern California, Los Angeles, CA.

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Summary
This summary is machine-generated.

Physician-modified endografts (PMEGs) offer extended endovascular repair for complex aortic aneurysms. Outcomes show good technical success and survival, especially in experienced centers, though risks like stroke and complications exist.

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Area of Science:

  • Vascular Surgery
  • Endovascular Repair
  • Aortic Aneurysm Treatment

Background:

  • Physician-modified endografts (PMEGs) were introduced in 2009 to address complex aortic anatomy.
  • PMEGs enable endovascular repair for challenging aneurysm cases previously requiring open surgery.

Purpose of the Study:

  • To review the current literature on Physician-modified endografts (PMEGs).
  • To assess the outcomes and safety of PMEGs in treating complex aortic diseases.

Main Methods:

  • A comprehensive literature review was conducted.
  • Included studies published within the last 10 years, focusing on PMEG use and guideline statements.

Main Results:

  • PMEGs are utilized for infrarenal, juxtarenal, pararenal, and thoracoabdominal aneurysms, including complex and emergent presentations.
  • Outcomes vary, with mortality ranging from 2-16.7% and major adverse events between 14.6-30.3%. Five-year survival is 41-69%.
  • For aortic arch disease, 30-day mortality is 1-6%, with low rates of stroke (2-5%) and no aneurysm-related mortality.

Conclusions:

  • PMEG use in experienced centers demonstrates high technical success, lasting branch patency, and acceptable survival.
  • Further data from registries and trials are needed to establish long-term durability and optimal device selection for PMEGs across all aortic segments.