Key result
Physician-modified fenestrated endograft achieves complete false lumen exclusion and positive aortic remodeling at 1 year.
Why the study?
Treatment of thoracoabdominal aortic aneurysm post aortic dissection carries a significant risk of spinal cord ischemia, and conventional endovascular treatment cannot preserve intercostal arteries.
Case Report (n=1)
A physician-modified endograft with posterior fenestrations successfully preserved intercostal artery perfusion and promoted positive aortic remodeling in a patient with chronic aortic dissection.
Physician-modified endografts with ICA fenestrations may offer a spinal cord protection strategy in post-dissection TAAA; leaves open need for prospective validation before practice change.
Treatment of thoracoabdominal aortic aneurysm post aortic dissection is challenging and carries a significant risk of spinal cord ischemia. Open surgery allows reimplantation of intercostal arteries (ICAs), whereas conventional endovascular treatment cannot. We report a 46-year-old patient treated with a physician-modified endograft with posterior fenestrations to preserve perfusion of ICAs. The device was deployed in the true lumen to maintain sealing, with a large fenestration aligned to the target ICAs. Two custom-made false lumen endoprostheses were also placed in the false lumen. The postoperative course was uneventful, and 1-year imaging showed complete false lumen exclusion and positive aortic remodeling.
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Bety et al. (2026) conducted a case report in Thoracoabdominal aortic aneurysm post aortic dissection (n=1). Physician-modified endograft with posterior fenestrations and custom-made false lumen endoprostheses was evaluated on Postoperative course and 1-year imaging outcomes (false lumen exclusion and aortic remodeling). Treatment with a physician-modified endograft with posterior fenestrations resulted in an uneventful postoperative course, complete false lumen exclusion, and positive aortic remodeling at 1 year.
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