Technical Approach to Rescuing a Previous Physician-Modified Endovascular Graft with a New Physician-Modified Endovascular Graft

Treatment with a PMEG may provide an endovascular solution for patients requiring urgent aneurysm repair even after a previous PMEG. This case also highlights the importance of anticipating a future proximal extension when planning a PMEGClinical ImpactThis article demonstrates the use of a physician-modified endovascular graft (PMEG) to reline and proximally extend a previously implanted PMEG requiring urgent repair. Although technically challenging, this approach provides a safe and effective endovascular solution for patients with a previous fenestrated endograft requiring urgent repair, thereby avoiding the need for open surgery. This case underscores the benefit of PMEGs to the vascular surgeon's armamentarium and emphasizes the importance of anticipating future reinterventions during primary procedures.