Key result
Physician-modified four-fenestration endograft achieves complete exclusion and ~100% visceral branch patency for ruptured aortic aneurysm.
Case Report (n=1)
No
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Endovascular repair has become a standardized approach for aortic diseases, but visceral branch involvement presents major technical challenges. Fenestrated repair allows aneurysm exclusion while maintaining organ perfusion, though custom-made devices are costly and often unavailable in urgent settings. We report the first physician-modified four-fenestration endograft (PMEG) procedure performed in Türkiye for a contained rupture of the visceral aorta. All four visceral branches were successfully revascularized with full exclusion of the aneurysm. The patient had an uneventful recovery, and one-month control computed tomography angiography confirmed complete graft integrity and patency of all visceral branches.
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İNCE et al. (2026) conducted a case report in Contained rupture of the visceral abdominal aorta (3.5 cm saccular aneurysm at the renal level with a short-segment dissection flap) (n=1). Physician-modified four-fenestration endograft (PMEG) using a Medtronic Valiant thoracic endograft (34x34x107 mm) with bridging stents (Lifestream and Restorer) to the celiac trunk, SMA, and bilateral renal arteries was evaluated on Aneurysm exclusion and visceral branch patency at 1-month computed tomography angiography. Physician-modified four-fenestration endograft repair achieved complete exclusion of a ruptured 3.5 cm visceral aortic aneurysm with 100% patency of all four visceral branches at 1 month.
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