Midterm outcomes of physician-modified endovascular grafts for repair of postdissection and degenerative thoracoabdominal aortic aneurysms

Objectives: Although physician-modified fenestrated and branched endografts (PMEGs) were proposed as an alternative to thoracoabdominal aortic aneurysms (TAAAs) repair in 2012, PMEG use is still limited by the lack of long-term data in large series. We seek to compare the midterm outcomes of PMEGs in patients with postdissection (PD) and degenerative (DG) TAAAs. Methods: Data were analyzed for 126 patients (age 68 ± 13 years; 101 men [80.2%]) with TAAAs treated by PMEGs from 2017 to 2020, including 72 PD-TAAAs and 54 DG-TAAAs. Early and late outcomes were compared between patients with PD-TAAAs and DG-TAAAs, including survival, branch instability, and freedom from endoleak and reintervention. Results: values > .05). Conclusions: Despite the difference in age, diabetes, prior history of aortic repair, and aneurysm size preoperatively, PMEGs achieved similar early and midterm outcomes in PD-TAAAs and DG-TAAAs. Patients with DG-TAAAs were more prone to early nonaortic complications, which represents an aspect for improvement to optimize outcomes and warrants further study.