Two years results of Physician Modified Gore Endovascular Grafts via PERTINI Method

BACKGROUND: Physician-modified endovascular grafts (PMEGs) are an upcoming treatment option for complex aortic aneurysms. Although its increasingly frequent use some questions remain unanswered regarding durability and outcomes. Our single-center experience with the use of PMEG Gore Excluder C3 aortic endoprosthesis via Pertini Method is reported.METHODS: A retrospective review of patients undergone PMEG AAA repair from September 2021 to January 2024 was performed. Primary endpoints included technical success, 30-day mortality, major adverse events (MAEs), branch instability, endoleaks, reintervention, and sac regression or expansion. A postoperative CT scan follow-up was planned and Aneurismal sac changes, fenestrations’ aspect modifications such as deformation or laceration, bridging stent modifications such as sealing zone length and aorta-target vessel angle were obtained.RESULTS: The average graft preparation-time was 46’ (min. 30’- max. 70‘). In all cases, graft-release was performed correctly with normal perfusion of fenestrations. Technical success was 100%. No procedure-related deaths nor MAEs occurred. Two endoleaks were reported (one type IA and one type II) and were promptly treated due to sac expansion. One branch occlusion was found but required no reintervention. No fenestrations aspect modification nor bridging stents modifications were found. Mean follow-up was 18 months (14-24).CONCLUSIONS: Despite the small number of cases our technique of PMEG repair of AAAs seems to be a feasible and effective procedure offering major advantages in terms of simplicity and speed of execution compared to other methods described previously. Positive preliminary results were found in terms of durability and reliability.