Modified fenestrated stent grafts: Device design, modifications, implantation, and current applications

Gustavo S. Oderich, Joseph J. Ricotta

Research output: Contribution to journalReview articlepeer-review

93 Scopus citations


Patients with aneurysms with short or angulated necks and those with involvement of the renal, visceral, and hypogastric arteries may not be candidates for endovascular treatment using infrarenal stent graft. Fenestrated stent grafts with reinforced fenestrations permit the incorporation of the visceral and renal arteries into the endovascular repair enabling an adequate proximal sealing zone. These devices require a 6-week to 8-week period for customization and are not currently commercially available in the United States. Modified fenestrated stent grafts may have a future role in the compassionate treatment of selected high-risk patients with complex aneurysms who otherwise would not have access to a manufactured fenestrated stent graft, or for those in need of urgent or emergent repair because of impending or contained ruptured, rapidly expanding or excessively large aneurysm. The authors have used modified fenestrated stent grafts selectively in patients with large aortoiliac, juxtarenal, pararenal, or thoracoabdominal aortic aneurysms. In this article, the authors summarize the principles applied for device design and procedure planning, as well as the technique for device modification and implantation.

Original languageEnglish (US)
Pages (from-to)157-167
Number of pages11
JournalPerspectives in Vascular Surgery and Endovascular Therapy
Issue number3
StatePublished - Sep 2009


  • Juxtarenal
  • Modified fenestrated branched endograft
  • Thoracoabdominal aneurysm

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine


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