These preliminary data suggest that endovascular repair with PMEG is safe and effective for managing patients with juxtarenal aortic aneurysms. Endovascular repair with PMEG has acceptable early rates of morbidity, mortality, and endoleak. This endovascular aortic strategy is particularly appealing for those patients presenting with symptomatic or ruptured aortic aneurysms until reliable off-the-shelf solutions become widely available.

These midterm results are favorable and verify our early report that endovascular repair with PMEG is safe and effective for managing patients with juxtarenal aortic aneurysms. PMEG has exceptional midterm rates of morbidity, mortality, and endoleak and may outperform standard endovascular aneurysm repair with favorable anatomy. In patients who are poor open surgical candidates who present with symptomatic or ruptured juxtarenal aortic aneurysms, PMEG continues to be an extremely appealing option as reliable off-the-shelf solutions are not widely available. Preoperative planning remains the key ingredient for success with use of these techniques.

This automated FEVAR planning software accurately and efficiently identifies fenestration locations for vital branch arteries, thus simplifying the planning process and facilitating the FEVAR procedure. Validated automated FEVAR planning could help bring this beneficial therapy to most patients harboring JAAAs.

Early-term data suggest that physician-modified fenestrated thoracic endografts can be used to safely and effectively treat TAAA in patients at high risk of open repair. Physician-modified devices perform similarly to commercially manufactured grafts in terms of treatment success, SCI, perioperative death, and clinical outcome at short-term follow-up. Physician modification is immediately available and allows for a high level of customizability. Procedure success is contingent upon careful preoperative planning, patient selection, experienced providers, and a high volume center.

Despite an increase in case complexity, there was evidence for significant improvement in important clinical and process outcomes during the study period. We believe that much of this improvement was attributable to several key advances in the FEVAR procedure that were instituted during the study period and are discussed herein.