Optimizing PMEG Technique: Enhancing Endovascular Repair With Pre-Manufactured Fenestrated Endografts

Use of a simplified PMEG with one prefabricated fenestration and diameter-reducing ties is feasible and offers favorable early outcomes with technical advantages in modification and deployment.Clinical ImpactUsing an endograft with a single prefabricated fenestration as the outset graft for physician-modified endografts enhances procedural efficiency by reducing customisation time and simplifying the modification process. This approach lowers technical complexity, improves procedural reproducibility, and broadens the applicability of PMEG techniques. Consequently, PMEGs can be more readily used across a wider range of complex aortic anatomies, expanding endovascular treatment options for patients who might otherwise have limited or higher-risk surgical alternatives.